Archived

Adaptation to Age-Related Vision Loss; Amy Horowitz, DSW/PhD, Principal Investigator; Joann Reinhardt, PhD, Co-Investigator; Robin McInerney Leonard, MA, Research Associate. Funded by the Community Trust of Greater New York. 1990-1991.

Age-Related Vision Loss: Factors Associated with Adaptation to Chronic Impairment Over Time; Amy Horowitz, DSW/PhD, Principal Investigator; Joann Reinhardt, PhD, Co-Investigator; Robin McInerney Leonard, MA, Project Director. Funded by the AARP Andrus Foundation. 1993-1995.

Friendship as a Resource in Age-Related Vision Loss; Joann P. Reinhardt, PhD, Principal Investigator; Robin McInerney Leonard, MA, Research Associate. Funded by the National Institute of Mental Health. 1991-1994.

Overview

For an older person who has been sighted until late life, the onset of vision impairment is a profound experience and one that requires considerable functional, emotional, and psychosocial adjustment. A series of three studies have examined the process and predictors of adaptation to age-related vision loss. These studies have focused on the effect of demographic characteristics, characteristics of the vision disability, concurrent health conditions, functional status, coping strategies and social support on adaptation outcomes. In addition, a major objective of the first study was the development and validation of a scale of adaptation to vision loss (AVL scale) specifically designed for elderly persons. The AVL scale has subsequently been used as an outcome measure in this series of studies, in addition to two other measures of global well-being: life satisfaction and depressive symptomatology.

The second study was a 2-year follow-up of the earlier participants in the first study (after service receipt), which permitted the examination of adaptation to age-related vision loss over time and the effect of varying levels of service on adaptation. The third study provided an in-depth examination of the quality of perceived support in visually impaired women and men, and specifically compared the effect of kin and nonkin support on adaptation to vision loss.

Findings

Multivariate analyses conducted in the first study suggested that several major conceptual domains contributed significantly to adaptation to age-related vision loss. Specifically, educational level, quality of family and friendship support, current type of coping strategies used to deal with the vision loss, and activity level emerged as the most significant domains in predicting adaptation.

Analyses of data in the two-year follow-up study focused on the identification of baseline predictors of Time-2 adaptation. Results demonstrated that less use of affective coping strategies, greater use of escape/compensatory coping strategies, better health at baseline and having one's service expectations met were significant predictors of each of the adaptation indicators. In addition, using a greater number of optical devices predicted more successful adaptation to the vision loss and lower levels of depression; receiving counseling predicted higher life satisfaction, and receiving low vision services predicted lower depression. Greater ADL disability at follow-up was predicted by poorer initial health status, more severe functional vision problems at both baseline and follow-up, lower perceived income adequacy and a decrease in contact with friends.

Results for the third study demonstrated that the majority (70%) of the sample of elder, visually impaired women and men had both a close friend and a close family member. Multivariate procedures demonstrated that after accounting for demographic, vision and health variables, and family support, friendship support predicted unique variance in adaptation variables. This was true even though descriptive data showed that most individual support components were significantly higher for family than friendship support. Selected significant differences by gender in perceived friend and family support components emerged, yet overall, females and males appeared to receive similar levels and types of support from kin and nonkin support providers. Thus, both kin and nonkin support is important for adaptation to vision loss.

Analyses of these data continue with a focus on the dual sensory impaired elderly, the effect of vision loss on specific functional tasks, coping strategies and adaptation, and the prevalence and predictors of depression among visually impaired elders.

Publications

Horowitz, A., & Reinhardt, J. P. (1998). Development of the Adaptation to Age-Related Vision Loss Scale. Journal of Visual Impairment & Blindness, 92, 30-41.

Horowitz, A., & Reinhardt, J. P. (2000). Depression among low vision elders. In C. Stuen, A. Arditi, A. Horowitz, M. A. Lang, B. Rosenthal, & K. Seidman (Eds.), Vision rehabilitation: Assessment, intervention, and outcomes (pp 655-658). Amsterdam: Swets and Zeitlinger.

Horowitz, A., Reinhardt, J. P., Boerner, K., & Travis, L. A. (2003). The influence of health, social support quality and rehabilitation on depression among disabled elders. Aging and Mental Health, 7(5), 342- 350.

Horowitz, A., Reinhardt, J. P., McInerney Leonard, R., & Balistreri, E. (1994). Age-related vision loss: Factors associated with adaptation to chronic impairment over time. Final Report Submitted to AARP Andrus Foundation. New York: Arlene R. Gordon Research Institute of The Lighthouse Inc.

McIlvane, J. M., & Reinhardt, J. P. (2001). The interactive effect of support from families and friends in visually impaired elders. Journal of Gerontology: Psychological Sciences.

Reinhardt, J. P. (1996). The importance of friendship and family support in adaptation to chronic vision impairment. Journal of Gerontology: Psychological Sciences, 51B, P268-P278.

Reinhardt, J. P. (2004). Vision impairment, late life adjustment, and rehabilitation. In C. B. Fisher & R. M. Lerner (Eds.), Applied developmental science: An encyclopedia of research, policies, and programs. Thousand Oaks: Sage.

Reinhardt, J. P., & Blieszner, R. (2000). Predictors of perceived support quality in visually impaired elders. Journal of Applied Gerontology, 19, 345-362.

Travis, L., Boerner, K., Reinhardt, J. P., & Horowitz, A. (in press). Functional disability in older adults with low vision. Journal of Visual Impairment and Blindness.

Travis, L., Boerner, K., Reinhardt, J., & Horowitz, A. (2004). Exploring Functional Disability in Older Adults with Low Vision. Journal of Visual Impairment & Blindness, 98(9), 534-545.

Presentations

Horowitz, A., & Reinhardt, J. P. (1993, November). Psychological well-being among older persons with concurrent age-related losses in vision and hearing. In Vision, hearing and psychological functioning: Constraints and reserves. Symposium conducted at the annual meeting at The Gerontological Society of America, New Orleans, LA.

Horowitz, A., & Reinhardt, J. P. (1996, December). Prevalence and predictors of depression among low vision elders. Paper presented at the annual conference of the American Academy of Optometry, Orlando, FL.

Horowitz, A., Reinhardt, J. P., & Brennan, M. (November, 2004). Psychosocial adaptation to age-related disability: The distinction between domain-specific and global indicators of well-being. In H.W. Wahl & A. Horowitz (Chairs), Adaptational resources under constraints: Aging with a chronic disability. Symposium presented at the annual scientific meeting of the Gerontological Society of America, Washington D.C.

Horowitz, A., & Silverstone, B. (1991, November). The paradox of 'blindness': Implications for adaptation to aging and disability in later life. Paper presented at the annual meeting of The Gerontological Society of America, San Francisco, CA.

Reinhardt, J. P., & Horowitz, A. (1992, November). Differential use of coping strategies in adaptation to chronic impairment. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Washington, D.C.

 

 

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