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The study aimed to examine the effect of visual impairment (VI), eye diseases, and other risk factors on health-related quality of life (HRQoL) in nursing home residents in Armenia. This cross-sectional study administered an interviewer-administered structured questionnaire to collect information about socio-demographics, chronic diseases, HRQoL, smoking, receiving and giving instrumental/emotional social support, and sleeping disorders among 313 nursing home residents. An ophthalmic examination of the participants was conducted. The mean age was 72.5 years, ranging from 45.5 to 91.4. Women constituted 50% of the sample. The prevalence of normal vision by presenting visual acuity with available correction was 55.3%, while VI and blindness were present in 40.8% and 3.9%, respectively. Uncorrected refractive error (URE) was found in 20% of participants. The mean HRQoL score was 51.3, ranging from 7.9 to 95.0. In the adjusted analysis, having at least one chronic non-communicable disease, sleeping disorders, eye diseases, URE, VI, blindness, and giving instrumental social support were associated with HRQoL. Regular eye care services could improve the eye health and HRQoL of nursing home residents. Interventions addressing vision loss and chronic non-communicable diseases could enhance the functioning and overall well-being of the target population. Visual impairment, as a leading cause of disability in older adults, leads to reduced health-related quality of life. This study found a high prevalence of visual impairment, blindness, and uncorrected refractive errors among nursing home residents. Visual impairment, blindness, uncorrected refractive error, chronic non-communicable diseases, sleep disorders, eye diseases, and instrumental social support were associated with health-related quality of life. Regular eye screening, treatment programs, and distribution of spectacles could improve eye health and health-related quality of life in nursing home residents. [ABSTRACT FROM AUTHOR]

This study assessed the prevalence of cataract blindness, cataract surgical coverage (CSC), effective CSC, visual outcome after cataract surgery, and barriers to cataract surgery in a population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. The study sample included 2258 individuals aged 50 years and older who were randomly selected from 11 provinces of Armenia in 2019 following the RAAB methodology. The study team randomly selected 50 clusters, 50 people in each. The RAAB survey form was used to collect information on cataract blindness, visual outcome after cataract surgery, and barriers to cataract surgery. The mean age of the participants was 65.3 (SD = 9.9) ranging from 50 to 99. The majority of participants were women (65.6%). Age- and sex-adjusted prevalence of blindness due to all causes was 1.5%; of which 36.4% was bilaterally blind due to cataract. The CSC and effective CSC at a cataract surgical threshold of <6/12 were 55.1% and 24.4%, respectively. Good outcome was reported in 43.7% of eyes after cataract surgery, borderline in 37.2% of eyes, and poor outcome in 19.1%. The main barriers to cataract surgery included "cost," "need not felt," or "fear." The prevalence of cataract blindness in our study was higher compared to high-income regions and lower than estimates from South/Southeast Asia. This study suggests the urgent need to update the National Strategic Plan to prevent blindness in Armenia with a focus on improving the quality and coverage of cataract surgery. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the prevalence and main causes of blindness and visual impairment in population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. The study team randomly selected 50 clusters (each consisting of 50 people) from all 11 regions of Armenia. Data on participants' demographics, presenting visual acuity, pinhole visual acuity, principal cause of presenting visual acuity, spectacle coverage, uncorrected refractive error (URE), and presbyopia were collected using the RAAB survey form. Four teams of trained eye care professionals completed data collection in 2019. Overall, 2,258 people of 50 years and older participated in the study. The age- and gender- adjusted prevalence of bilateral blindness, severe and moderate visual impairment were 1.5% (95% CI: 1.0–2.1), 1.6% (95% CI: 1.0–2.2) and 6.6% (95% CI: 5.5–7.7), respectively. The main causes of blindness were cataract (43.9%) and glaucoma (17.1%). About 54.6% and 35.3% of participants had URE and uncorrected presbyopia, respectively. The prevalence of bilateral blindness and functional low vision increased with age and was the highest in participants 80 years and older. The rate of bilateral blindness was comparable with findings from countries that share similar background and confirmed that untreated cataract was the main cause of blindness. Given that cataract blindness is avoidable, strategies should be developed aiming to further increase the volume and quality of cataract care in Armenia. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems throughout the world. Many patients faced delays and cancellation of care due to scaled back services, mobility restrictions, and concerns related to the risk of infection. The present study aimed to assess the prevalence of and risk factors associated with the avoidance or delay of medical care due to COVID-19 in Armenia. Methods: We conducted a cross-sectional telephone survey of 3,483 adults across Armenia. We used stratified two-stage cluster sampling to select the participants from different age groups proportionate to their size in the population. Logistic regression analysis assessed the association of risk factors with avoidance/delay of routine, urgent/emergency, and any medical care. Results: The mean age of the sample was 49.5 (SD = 14.8), ranging from 18 to 90. About 9.9% of the respondents avoided/delayed any type of medical care; whereas 5.5% avoided/delayed urgent/emergency care and 6.6% routine care. In the adjusted analysis, female gender and higher monthly expenditures were associated with avoidance/delay of routine medical care. Factors associated with delay/avoidance of urgent/emergency care included female gender and higher perceived threat of COVID-19. Younger age, female gender, higher perceived threat and not being vaccinated against COVID-19 were associated with avoidance/delay of any medical care in the adjusted analysis. Conclusion: Since avoiding or delaying care might increase morbidity and mortality associated with conditions not related to COVID-19, identifying population groups that are more likely to avoid care is important. Targeting such groups with educational interventions focusing on the risks of using versus not using medical care in times of pandemic might be crucial. Ensuring the provision of in-home healthcare services for high-risk groups might help to address important medical care needs during the pandemic. [ABSTRACT FROM AUTHOR]

Cataract surgery helps to enhance visual function and improve the quality of life of cataract patients. The present study assessed visual outcomes and explored health-related quality of life (HRQoL) and factors associated with it following cataract surgery in Armenia. An interviewer-administered survey along with the ophthalmologic examination was conducted among 248 patients. It explored socio-demographic characteristics, use of eye care services, smoking status, comorbidities, and receiving and giving social support. A Short Form Health Survey (SF-36) was used to measure HRQoL. Simple and multivariable linear regression was used for the analysis. About 72.8% of examined eyes had good visual outcomes, while 17.7% had borderline outcomes. Poor visual outcomes were detected in 9.5% of the eyes. The mean composite SF-36 score for physical health was 50.8, while the mean composite score for mental health was 49.9. Gender, socioeconomic status, having a non-communicable disease, and receiving and giving tangible social support were significantly associated with SF-36 physical component in the adjusted analysis, while the variables which demonstrated significant association with the mental component included socioeconomic status, having a non-communicable disease, and giving tangible support. The visual outcome after cataract surgery in Armenian patients is below WHO-recommended standards. The quality of ophthalmological surgical care should be monitored to maximize the visual outcome in Armenian patients, with a focus on women, patients with poor socioeconomic status, and those with non-communicable diseases. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to examine the effect of visual impairment, eye diseases and other risk factors on health‐related quality of life (HRQoL) in retirement home residents in Armenia. Methods: The survey was conducted among 313 beneficiaries from retirement homes. Interviewer‐administered structured questionnaire explored socio‐demographic characteristics of participants, presence of chronic non‐communicable diseases, depressive symptoms, HRQoL, smoking, physical activity, receiving and giving instrumental and emotional social support, sleeping disorder, and adverse life events. Ophthalmic examinations were conducted to assess participants' visual acuity and presence of eye diseases. Results: The mean age was 72.5 years. Women constituted 50% of the sample. About 28% of participants reported depressive symptoms. The prevalence of normal vision was 49%, mild/moderate and severe visual impairment was 46%, and blindness was 5%. Uncorrected refractive errors were found in 20% of participants. In the adjusted linear regression model, presence of chronic non‐communicable diseases (β = −11.3; CI: −15.3; −7.39), physical activity (β = 15.3; CI: 9.04; 21.5), sleeping disorders (β = −5.58; CI: −10.2; −0.96), receiving emotional support (β = 0.09; CI: 0.01; 0.17) and giving instrumental support (β = 0.17; CI: 0.08; 0.25), presence of depressive symptoms (β = −11.7; CI: −16.0; −7.46) and uncorrected refractive errors (β = −9.15; CI: −17.3; −1.04) were associated with HRQoL. Conclusions: This study found high prevalence of uncorrected refractive errors, visual impairment and blindness among people in retirement homes. Regular eye screening programs and distribution of spectacles could improve eye health in the target population. Promote healthy behaviours including regular physical activity to enhance HRQoL. A focus on people with chronic non‐communicable diseases and depressive symptoms is warranted. [ABSTRACT FROM AUTHOR]

Objectives: Visual impairment in older adults is a major public health problem. Untreated visual impairment might negatively impact physical and psychological health. This study assessed the association between visual impairment and depression among socially vulnerable older adults (those aged 50 and above) in Armenia.Method: The survey and eye screenings were carried out among 339 participants who were the residents of retirement homes and single older adults in the households. The study team used Golovin–Sivtsev chart and cycloplegic skiascopy to measure visual impairment and Center for Epidemiologic Studies Depression scale to measure depression.Results: The prevalence of visual impairment in the sample was 13.3%. Almost 24.0% of participants reported depression symptoms. Participants living in the retirement homes had substantially higher rates of visual impairment (21.5%) and depression (28.0%) than those living in households (9.3% and 15.0%, respectively). The odds of having depression were higher among those with visual impairment compared to those without after adjusting for confounders (OR = 2.75; 95% CI: 1.29–5.87). Having at least one non-communicable disease was associated with depression (OR = 2.47; 95% CI: 1.28–4.75). Living in the retirement home was marginally significantly associated with having depression. Other confounders included age, gender, education, physical activity, and smoking.Conclusion: Visual impairment was significantly associated with depression in socially vulnerable older adults in Armenia. Timely eye screenings in similar population groups could lead to early detection of visual impairment and prevention of visual loss and associated mental health problems. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the prevalence of visual impairment (VI) and the association between VI and health‐related behaviours in population aged 50 years and older in Gegharkunik province of Armenia. Methods: Twenty‐four clusters with 50 people in each were sampled for the interviewer‐administered survey in Gegharkunik in 2019. Ophthalmic examination assessed presenting and pinhole corrected visual acuity using Rapid Assessment of Avoidable Blindness methodology. The structured questionnaire collected information about participants' socio‐demographics, body mass index, self‐assessed general health status, utilisation of eye services, presence of chronic non‐communicable diseases, and health‐related behaviours (smoking, physical activity and alcohol consumption). Results: The mean age of participants was 64.8 (SD = 10.2), ranging from 50 to 97. Women constituted 62.4% of the sample. About 26% of participants had mild to severe VI and 2% were blind. Approximately 58% of participants were physically inactive or insufficiently active. Most of the respondents never used alcohol (62.5%), while 33.4% were moderate and 4.1% were heavy alcohol users. After adjusting for health characteristics and health‐related behaviours, being physically inactive or insufficiently active was associated with VI in the first logistic regression model. Advanced age and self‐assessed "poor" general health status were associated with VI after adjusting for demographics, health characteristics and health‐related behaviours. Moderate alcohol consumption had protective effect on VI in both models. Conclusion: The prevalence of VI in this population was higher compared to the global rate and estimates from the European region. Regular ophthalmic examination and public health interventions might reduce VI and improve health‐related behaviours among target population. [ABSTRACT FROM AUTHOR]

Purpose: Glaucoma is the leading cause of global irreversible blindness and the second leading cause of blindness globally. This study assessed the association between migraine headaches and high tension glaucoma among adult population living in Armenia. Methods: This case‐control study recruited 145 cases and 250 controls from Optomed Canada Eye Diagnostic Center (OCEDC) in Armenia. Cases were patients with glaucoma, while controls were patients with no glaucoma and no other ocular disorders except refractive errors. A structured interviewer‐administered questionnaire contained socio‐demographic questions, family history of glaucoma and stroke, smoking status, migraine and obstructive sleep apnea. The details on ocular health were retrieved from patients' medical records. This study used Migraine Screening Questionnaire for assessment of possible migraine and Berlin Questionnaire to assess obstructive sleep apnea. Results: Mean age of cases and controls was 62.8 (SD = 12.6) and 39.5 (SD = 13.5), respectively. Women comprised 64.1% of cases and 69.1% of controls in the sample. About 17.5% of cases and 19.0% of controls were identified having possible migraine. In the adjusted analysis age (OR = 1.15; 95% CI: 1.10; 1.19), having average and lower than average socio‐economic status (OR = 3.45; 95% CI: 1.04; 11.4) and family history of glaucoma (OR = 3.96; 95% CI: 1.56; 10.1) were significantly associated with glaucoma. Conclusion: This study found no statistically significant association between migraine headache and high tension glaucoma. Due to the limited number of cases with normal tension glaucoma in the sample, the study could not assess its associations with migraine. Timely screenings for eye pathologies among those with average/low socio‐economic status could facilitate early detection of eye diseases and help to prevent visual loss. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the association between migraine headache and glaucoma among the adult population living in Armenia., Methods: This case-control study recruited 145 cases with glaucoma and 250 controls without glaucoma and other ocular disorders except refractive error from Optomed Canada Diagnostic Eye Center in Armenia. A structured questionnaire contained questions on socio-demographics, family history of glaucoma and stroke, ocular health, smoking, migraine, and obstructive sleep apnea. The Migraine Screening Questionnaire assessed possible migraine and the Berlin Questionnaire measured obstructive sleep apnea., Results: The mean ages of cases and controls were 63.3 (SD = 12.3) and 39.5 (SD = 13.5), respectively. Females comprised 62.8% of cases and 69.1% of controls. A total of 17.8% of cases and 19.0% of controls had possible migraine. In the adjusted analysis older age (OR 1.17; 95% CI 1.12; 1.23), average/lower than average socio-economic status (OR 5.27; 95% CI 1.30; 21.3), and family history of glaucoma (OR 4.25; 95% CI 1.51; 11.9) were associated with high-tension glaucoma., Conclusion: Timely case detection of glaucoma among those with average/low socio-economic status and those with family history of glaucoma could prevent further progression of the disease. Further studies to explore the relationship between migraine headache and specific types of glaucoma may be worthwhile., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Visual impairment (VI) and blindness remain serious public health problems among patients with diabetes. This study assessed the prevalence of VI and its associated risk factors in individuals with diabetes mellitus (DM) in Armenia., Methods: This cross-sectional study recruited 1287 people with DM. All participants underwent comprehensive ophthalmic examination and responded to a structured questionnaire on sociodemographic and health characteristics, health-seeking behavior, and ocular health. The presence of eye diseases and VI was defined based on the International Classification of Diseases-11. Descriptive statistics and logistic regression were used to address the study objectives., Results: The mean age of participants was 61.5 (SD = 9.6) ranging from 19.4 to 99.8 years. The mean duration of diabetes was 7.4 years. The majority of participants (70.5%) were women. The prevalence of VI and blindness was 12.1% and 0.9%, respectively. Overall, 22.4% of participants had diabetic retinopathy. In the adjusted analysis, advanced age (OR = 1.08; 95%CI: 1.06-1.11), higher education (OR = 0.37; 95%CI: 0.19-0.74), diabetes duration (OR = 1.05; 95%CI: 1.02-1.08), the presence of diabetic retinopathy (OR = 3.61; 95%CI: 2.38-5.46), age-related macular degeneration (OR = 1.88; 95%CI: 1.15-3.05), cataract (OR = 2.45; 95%CI: 1.66-3.63), and glaucoma (OR = 2.32; 95%CI: 1.25-4.30) were associated with VI., Conclusion: The findings highlight the importance and need for regular eye screening and diabetes prevention programs in the country. Continuous educational programs on diabetes self-management among patients with DM can reduce complications of diabetes including vision loss due to diabetes., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Introduction: Low- and middle-income countries often face the issue of unequal distribution of healthcare services and human resources between rural and urban areas. Globally, there are many factors negatively affecting the willingness of physicians to work in remote and rural areas, such as low wages, poor living conditions, poorer and sicker patients, suboptimal equipment and supplies, and a lack of quality infrastructure and transportation., Methods: This study explored the perceptions of barriers and facilitators of medical entrepreneurship and the impact of medical entrepreneurship on the served communities among the owners of private medical practices in rural and semirural areas of Armenia. The researchers conducted qualitative in-depth interviews with the 13 owners of 12 private practices. The interviews were transcribed in the original language (Armenian). Only the quotes were translated into English. The direct content analysis approach was used for analyzing textual data., Results: The findings of the study suggest that high investment cost, intense competition with state facilities, unfavorable laws and regulations, and a lack of entrepreneurship and healthcare quality assurance skills were perceived as barriers to establishing and running private healthcare practices. The dissatisfaction of healthcare providers with their work conditions in state facilities, the instability of the job market in Armenia, and the development of clear marketing strategies by the entrepreneurs facilitated opening and operating private practices. All of the interviewees felt that their practices had a positive impact on the communities they served, in terms of creating new jobs and introducing up-to-date and in-demand services into these communities., Conclusion: The study recommended providing potential entrepreneurs with training in entrepreneurship and healthcare quality assurance and mentorship opportunities, as well as with tools to support financing their enterprises.

Background: Diabetic retinopathy (DR) is one of the leading causes of blindness in adults in industrialized countries and the emerging cause of blindness in developing countries. The objective of this study was to describe the prevalence of DR and risk factors associated with it among diabetic patients., Methods: The analytical cross-sectional survey and eye screenings were carried out among 625 diabetic patients from urban and rural areas of Gegharkunik region. DR was assessed by dilated ophthalmoscopy and defined based on the WHO International Classification of Diseases. The survey instrument, included questions about demographics, disease history, health status, medication use and healthy lifestyle. Descriptive statistics and logistic regression were used to analyze the data., Results: The prevalence of DR in the sample was 36.2%. A total of 90.2% of patients with DR had non-proliferative, while 9.8% had proliferative DR. In bivariate analysis, age, diabetes duration, being under insulin treatment, blood glucose level, having non-communicable diseases were significantly associated with DR. In the adjusted analysis being under insulin treatment (OR = 3.24; 95% CI: 1.56-6.75), diabetes duration (OR = 1.23; 95% CI: 1.16-1.31) and age (OR = 1.05; 95% CI: 1.02-1.08) were independently associated with DR., Conclusion: Earlier diagnosis of diabetes and DR can help to control some of these factors and prevent further complications and vision loss. Population-based educational programs on diabetes and diabetic retinopathy and continuous medical education on diabetes management can improve diabetes care and self-management and prevent eye complications.