In 1995, The Lighthouse Inc. commissioned Louis Harris and Associates to conduct a nationwide survey of adults 45 years and older, focusing specifically on aging and vision loss, to provide current data on the prevalence of self-reported vision impairment, public attitudes and knowledge about vision loss and use of vision rehabilitation services, and the impact of vision impairment on everyday life. Funding was received from the AARP Andrus Foundation in 1996 to conduct multivariate, secondary analyses among respondents aged 55 years and older in six areas with direct relevance to maintaining independence in later life: (1) factors associated with older Americans' attitudes, knowledge, and fears about vision loss and aging, (2) risk factors associated with self-reported vision impairment in later life, (3) the unique impact of vision impairment on the quality of life of older Americans, (4) factors associated with more positive psychosocial and functional status among older adults with a vision impairment, (5) factors associated with service knowledge and service utilization among older Americans with a vision impairment, and (6) the social, health and vision-related characteristics that differentiate older drivers and nondrivers who are visually impaired.
A total of 1,219 telephone interviews were conducted nationwide including an oversample of persons age 75 and older. A two-stage weighting procedure was utilized to ensure that the sample parameters were representative of the population at large. Respondents were classified as visually impaired based on multiple indicators of vision problems including blind in one or both eyes, inability to read newspaper print or recognize a friend across the room, or self-rated poor or very poor vision, or any other reported trouble seeing even when wearing corrective lenses. Respondents were further classified as moderately or severely visually impaired. A subsample of 861 respondents aged 55 years and older was used for the secondary analyses funded by the AARP Andrus Foundation.
Results indicated that self-reported vision impairment is greater than estimated previously, with 15% of 45-64 year-olds, 17% of those aged 65-74 years, and more than one-fourth (26%) of elders 75 years and older classified as visually impaired, and half report that a vision problem interferes with their daily lives. Furthermore, there is pervasive fear of blindness among older adults and limited knowledge about agerelated vision loss. Knowledge about the availability of vision rehabilitation is seriously lacking among those who may be the most in need: the elderly, the least educated, and those with severe visual impairments. Secondary analyses have suggested numerous implications including: (1) expand outreach to educate older people about age-related vision loss, basic eye care, and vision rehabilitation; (2) target outreach at those most at risk for late-life vision loss, namely those with greater age, lower education, and limited informal social support; (3) target vision rehabilitation at those with greatest risk to functional and psychosocial well-being (i.e., young elderly, non-Whites, those in poor health, persons with low education or income); (4) increase public education on the benefits of vision rehabilitation in terms of life quality, especially in minority and low-income communities, which include interactions between visually impaired and sighted persons to promote positive attitudes towards vision loss; (5) educate the public and eye care professionals about the benefits of low vision care and other adaptive devices; and (6) conduct future research on how older adults modify driving behaviors in response to vision impairment.
Since the completion of the AARP grant, two additional secondary analyses have been conducted with these data. The first project was designed to examine the impact of vision impairment among a subsample of retirees 55 years and older (n = 558) with regard to previously identified predictors of wellbeing in late adulthood. Findings indicated that retirees with visual impairments (20%) were significantly older, had lower education levels, were more likely to have poverty-level incomes, and were more likely to report poor health as compared with their peers. Retirees with vision impairment also reported a significantly greater number of problems in their lives compared to nonimpaired adults. Multivariate analysis revealed that severe visual impairment was a unique predictor of greater life problems among retirees, even after controlling for age, health, income, and minority status.
A second project examined the effects of visual impairment on employment status among respondents aged 45 to 69 years (n = 702), among whom 14% (n = 97) were visually impaired. There was no significant difference in the proportion of persons with visual impairments and nonimpaired adults who were employed (60% and 63%, respectively). Among respondents with visual impairments, only use of an optical device significantly predicted employment status; those using optical devices were 70% less likely to be currently employed as compared with nonusers. The use of an optical device may be considered a proxy for visual impairment severity, so these findings indicate that as severity increases, the prospects of employment for adults with vision loss is significantly diminished.
Brennan, M., Horowitz, A., & Reinhardt, J. P. (in press). Understanding older Americans' attitudes, knowledge, and fears about vision loss and aging. Journal of Social Work in Disability and Rehabilitation.
Horowitz, A., Reinhardt, J. P., & Brennan, M. (1997). Aging and vision loss: Experiences, attitudes and knowledge of older Americans. Final Report submitted to the AARP Andrus Foundation. New York: Arlene R. Gordon Research Institute of The Lighthouse Inc.
The Lighthouse Inc. (1995). The Lighthouse national survey on vision loss: The experience, attitudes and knowledge of middle-aged and older Americans. (Executive Summary). New York: The Lighthouse Inc.
Brennan, M., Horowitz, A., & Reinhardt, J. P. (2004). Understanding older Americans' attitudes, knowledge, and fears about vision loss and aging. Journal of Social Work in Disability and Rehabilitation, 3 (3), 17-38.
Horowitz, A., Brennan, M., & Reinhardt, J. P. (2005). Prevalence and risk factors for self-reported visual impairment among middle-age and older adults. Research on Aging, 27 (3), 307-326.
Brennan, M., Horowitz, A., & Reinhardt, J. P. (1997, November). Factors associated with risk of selfreported vision impairment in later life. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Cincinnati, OH.
Horowitz, A., Brennan, M., & Reinhardt, J. P. (1997, November). Prevalence and predictors of driving among older adults with self-reported vision impairment. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Cincinnati, OH.
Horowitz, A., Reinhardt, J. P., Brennan, M., Goodman, C. R., & Cantor, M. (1996, November). The impact of age-related vision impairment on life quality: Findings from The Lighthouse national survey on vision loss. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Washington, D.C.
Leonard, R., D'Allura, T., & Brennan, M. (1997, October). Chronic impairment and retirement status in older Americans. Paper presented at the annual meeting of the State Society on Aging of New York, Albany, NY.
Reinhardt, J. P., Horowitz, A., & Brennan, M. (1997, November). Factors associated with older Americans' attitudes, knowledge, and fears about vision loss and aging. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Cincinnati, OH.
Reinhardt, J. P., Horowitz, A., Brennan, M., Goodman, C. R., & Cantor, M. (1996, November). Predictors of psychosocial and functional adaptation in visually impaired older Americans. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Washington, DC.
Verini, E., D'Allura, T., Brennan, M., Horowitz, A., & Reinhardt, J. P. (1998). Employment among American adults with visual impairments: Secondary analyses of The Lighthouse national survey on vision loss and aging. Unpublished manuscript.
Investigators: Amy Horowitz, DSW/PhD, Principal Investigator
Joann P. Reinhardt, PhD, Co-Principal Investigator
Mark Brennan, PhD, Research Associate
Barbara Silverstone, DSW, Consultant
Prof. Marjorie Cantor, Consultant
Project Period: Field work completed 1994; descriptive report issued in April 1995; secondary analyses for AARP Andrus completed April 1997, further analyses ongoing.