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53. Digital Technology Use Among Older Adults With Vision Impairment

Author

Thomas, Jonathan, Almidani, Louay, Swenor, Bonnielin K., and Varadaraj, Varshini

Abstract

IMPORTANCE: Telehealth has the potential to improve health for older adults, but many access disparities exist, including for those with vision impairment (VI). OBJECTIVE: To examine the associations between VI and digital technology access measures in US older adults. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study that included Medicare beneficiaries 65 years and older. Beneficiary data were obtained from the National Health and Aging Trends Study (NHATS) 2021; data collection was conducted from June 2020 through January 2021. Data were analyzed September 2023. EXPOSURE: VI, measured on categorical (distance and near VI [>0.30 logMAR], contrast sensitivity impairment [CSI; <1.55 logCS], and any VI [distance VI, near VI, or CSI]), and continuous (distance and near acuity [logMAR] and contrast sensitivity [logCS]) scales. MAIN OUTCOMES: Self-reported outcomes of digital technology access from the technological environment component of the NHATS. RESULTS: Of the 2822 Medicare beneficiaries (mean [SD] age, 78.5 [5.6] years; 1605 female [54.7%]) included in this study, patients self-identified with the following race and ethnicity categories (weighted percentages): 575 non-Hispanic Black (8.0%), 132 Hispanic (7.0%), 2019 non-Hispanic White (81.7%), and 63 non-Hispanic other race (3.4%), which included American Indian, Alaska Native, Asian, multiracial, Native Hawaiian, Pacific Islander, or other specified race. A total of 1077 of 2822 patients (32.3%) had any VI. In multivariable logistic regression models, older adults with any VI had lower odds of having or knowing how to use a cellphone (odds ratio [OR], 0.58; 95% CI, 0.38-0.88), computer (OR, 0.61; 95% CI, 0.47-0.79), or tablet (OR, 0.68, 95% CI = 0.54-0.85) than peers without VI. In other models, near VI was associated with lower odds of having and knowing how to use a phone (OR, 0.56; 95% CI, 0.36-0.87), computer (OR, 0.57; 95% CI, 0.44-0.75), or tablet (OR, 0.65; 95% CI, 0.52-0.81) compared with no near VI. CSI was associated with lower odds of having and knowing how to use a phone (OR, 0.66; 95% CI, 0.45-0.99) or computer (OR, 0.72; 95% CI, 0.55-0.93) compared with no CSI. Distance VI was only associated with lower odds of having and knowing how to use a cellphone (OR, 0.63; 95% CI, 0.41-0.95). Any VI and individual categorical VI measures were not associated with other outcomes of digital health– and nonhealth-related experiences. Similar associations were noted when vision was examined on a continuous scale. However, worse distance acuity (per 0.1 logMAR) was associated with being less likely to visit with family or friends on a video call (OR, 0.91; 95% CI, 0.84-0.98) and to order or refill prescriptions online (OR, 0.90; 95% CI, 0.83-0.97). CONCLUSIONS AND RELEVANCE: Results suggest that older US adults with VI were less likely to have access to digital technology than peers without VI, although no differences were noted in the report of digital health– and nonhealth-related activities. These findings highlight the potential for inequities that may arise in telehealth for older adults with VI and the necessity to develop strategies to improve accessibility of telemedicine for all.

Published
2024
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54. Prevalence and impact of combined vision and hearing (dual sensory) impairment: A scoping review

Author

Bright, Tess, primary, Ramke, Jacqueline, additional, Zhang, Justine H., additional, Kitema, Gatera Fiston, additional, Safi, Sare, additional, Mdala, Shaffi, additional, Yoshizaki, Miho, additional, Brennan-Jones, Christopher G., additional, Mactaggart, Islay, additional, Gordon, Iris, additional, Swenor, Bonnielin K., additional, Burton, Matthew J., additional, and Evans, Jennifer R., additional

Published
2023
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56. Sensory impairment and algorithmic classification of early cognitive impairment

Author

Cai, Yurun, primary, Schrack, Jennifer A., additional, Gross, Alden L., additional, Armstrong, Nicole M., additional, Swenor, Bonnielin K., additional, Deal, Jennifer A., additional, Lin, Frank R., additional, Wang, Hang, additional, Tian, Qu, additional, An, Yang, additional, Simonsick, Eleanor M., additional, Ferrucci, Luigi, additional, Resnick, Susan M., additional, and Agrawal, Yuri, additional

Published
2023
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66. Self-Reported Vision Impairment and Food Insecurity in the US: National Health Interview Survey, 2011–2018.

Author

Kumar, Priyanka, Brinson, Jessica, Wang, Jiangxia, Samuel, Laura, Swenor, Bonnielin K., Scott, Adrienne W., and Varadaraj, Varshini

Subjects
FOOD security, VISION disorders, POOR people, HEALTH surveys, LOGISTIC regression analysis
Abstract

To determine if vision impairment (VI) is associated with food insecurity among the United States (US) adults. This is a cross-sectional study of US adults ≥18 years below a threshold of 150% poverty from the National Health Interview Survey (NHIS), years 2011–2018. Outcome measures included food insecurity status, based on response to the NHIS adult (10-item) food insecurity tool, either as a binary (food secure or insecure) or ordinal (high, marginal, low, and very low) variable. VI was defined as self-reported trouble seeing, even when wearing glasses or contact lenses. Multivariable logistic regression analyses adjusted for potential confounders examined associations between VI and food insecurity. Participants (N = 62075) were majority female (57%), White (62%), and non-Hispanic (74%). Of them, 16% reported VI and 28% were food insecure. In fully adjusted logistic regression models, adults with VI had 216% higher odds (95% CI = 2.01–2.31) of being food insecure than adults without VI. Further, there was a dose–response relationship between VI and food insecurity noted in a multinomial model: VI predicted 159% higher risk of marginal food security (95% CI = 1.44–1.75), 197% higher risk of low food security (95% CI = 1.80–2.16), and 295% higher risk of very low food security (95% CI = 2.69–3.22), as compared to high food security. VI is associated with food insecurity, increasingly so among adults with highest levels of food insecurity in this national sample of low-income US adults. This data highlights the need for targeted interventions to address and reduce the burden of food insecurity among US adults with VI. [ABSTRACT FROM AUTHOR]

Published
2023
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71. The development of the Supplemental Nutrition Assistance Program enrollment accessibility (SNAP-access) score

Author

Samuel, Laura J., primary, Xiao, Emily, additional, Cerilli, Caroline, additional, Sweeney, Fiona, additional, Campanile, Jessica, additional, Milki, Nubaira, additional, Smith, Jared, additional, Zhu, Jiafeng, additional, Yenokyan, Gayane, additional, Gherman, Adi, additional, Varadaraj, Varshini, additional, and Swenor, Bonnielin K., additional

Published
2022
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73. Concurrent hearing and vision impairment and 8‐year memory decline in community‐dwelling older adults.

Author

Huang, Alison R., Rebok, George W., Swenor, Bonnielin K., Reed, Nicholas, Griswold, Michael, Zhu, Xiaoqian, and Deal, Jennifer A.

Abstract

Background: Hearing and vision impairments are risk factors for cognitive decline; less is known about dual sensory impairment. This study quantifies the association between dual sensory impairment and 8‐year change in memory among older adults. Methods: Data (N = 5552) were from the National Health and Aging Trends Study. Memory (immediate/delayed word recall, subjective memory) was measured annually (2011 to 2019). Hearing and vision impairments were measured by self‐report. Association between dual sensory impairment and 8‐year change in memory was assessed using multivariate linear mixed effect models and generalized logistic mixed models. Results: Rate of memory decline was most accelerated among participants with dual sensory impairment. For example, 8‐year decline in delayed word recall was −1.03 (95% confidene interval: ‐1.29, ‐0.77) for dual sensory impairment versus ‐0.79 (‐0.92, ‐0.67) for single and −0.56 (‐0.63, ‐0.48) for no impairment. Conclusion: Older adults with dual sensory impairment may be at particularly higher risk for cognitive decline. [ABSTRACT FROM AUTHOR]

Published
2023
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82. The development of the Supplemental Nutrition Assistance Program enrollment accessibility (SNAP-Access) score

Author

Samuel, Laura J, primary, Xiao, Emily, additional, Cerilli, Caroline, additional, Sweeney, Fiona, additional, Campanile, Jessica, additional, Milki, Nubaira, additional, Smith, Jared, additional, Zhu, Jiafeng, additional, Yenokyan, Gayane, additional, Gherman, Adi, additional, Varadaraj, Varshini, additional, and Swenor, Bonnielin K, additional

Published
2022
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83. sj-docx-1-jvb-10.1177_0145482X221132844 - Supplemental material for Stigma Among Older Adults with Age-Related Vision Impairments

Author

Kumar, Priyanka, Campanile, Jessica, Swenor, Bonnielin K., and Varadaraj, Varshini

Subjects
Education
Abstract

Supplemental material, sj-docx-1-jvb-10.1177_0145482X221132844 for Stigma Among Older Adults with Age-Related Vision Impairments by Priyanka Kumar, Jessica Campanile and Bonnielin K. Swenor, Varshini Varadaraj in Journal of Visual Impairment & Blindness

Published
2022
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85. Additional file 7 of Demographics, clinical interests, and ophthalmology skills confidence of medical student volunteers and non-volunteers in an extracurricular community vision screening service-learning program

Author

Burton, Eleanor, Assi, Lama, Vongsachang, Hursuong, Swenor, Bonnielin K., Srikumaran, Divya, Woreta, Fasika A., and Johnson, Thomas V.

Abstract

Additional file 7: Table S1. ViSION volunteers��� motives for joining, continuing, and terminating ViSION involvement based on survey responses.

Published
2022
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86. Additional file 1 of Demographics, clinical interests, and ophthalmology skills confidence of medical student volunteers and non-volunteers in an extracurricular community vision screening service-learning program

Author

Burton, Eleanor, Assi, Lama, Vongsachang, Hursuong, Swenor, Bonnielin K., Srikumaran, Divya, Woreta, Fasika A., and Johnson, Thomas V.

Abstract

Additional file 1. Survey Outline: Start of Block: Part 1 for all current or former JHUSOM students

Published
2022
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89. Vision Impairment and Patient Activation among Medicare Beneficiaries.

Author

Assi, Lama, Kozhaya, Karim, Swenor, Bonnielin K., and Reed, Nicholas S.

Subjects
VISION disorders, PATIENT participation, LOW vision, MEDICARE beneficiaries, MEDICAL care use, HEARING disorders
Abstract

Low patient activation is associated with poor patient outcomes. People with vision impairment may have low patient activation as a result of communication and access barriers. We examined the association of patient activation with vision impairment. Cross-sectional study using the 2016 Medicare Current Beneficiary Survey. Older Medicare beneficiaries, without dementia, who completed the topical patient activation questionnaire were included. The primary exposure was self-reported vision impairment (no vision impairment, a little vision impairment, a lot of vision impairment), and the secondary exposure was dual sensory impairment (no sensory impairment, vision impairment only, hearing impairment only, dual sensory impairment). Patient activation scores were categorized as low, moderate, or high based on their distribution around the mean. Multivariable-adjusted ordinal regression models examined the association of patient activation with vision impairment, and then with dual sensory impairment. In total, 6,683 participants were included. Those with a little vision impairment had 20% lower odds of higher patient activation (odds ratio [OR] = 0.80, 95% confidence interval [CI] = 0.71–0.90), and those with a lot of vision impairment had 26% lower odds of higher patient activation (OR = 0.74, 95% CI = 0.55–0.98). In the second model, having vision or hearing impairment only was associated with lower odds of higher activation than having no sensory impairment. Having dual sensory impairment was associated with even lower odds of higher activation. Older Medicare beneficiaries with sensory impairment may be a group to target to improve patient activation levels, which could potentially improve health outcomes and health care utilization patterns in this population. [ABSTRACT FROM AUTHOR]

Published
2023
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97. Grand Challenges in global eye health: a global prioritisation process using Delphi method

Author

Ramke, Jacqueline, primary, Evans, Jennifer R, additional, Habtamu, Esmael, additional, Mwangi, Nyawira, additional, Silva, Juan Carlos, additional, Swenor, Bonnielin K, additional, Congdon, Nathan, additional, Faal, Hannah B, additional, Foster, Allen, additional, Friedman, David S, additional, Gichuhi, Stephen, additional, Jonas, Jost B, additional, Khaw, Peng T, additional, Kyari, Fatima, additional, Murthy, Gudlavalleti V S, additional, Wang, Ningli, additional, Wong, Tien Y, additional, Wormald, Richard, additional, Yusufu, Mayinuer, additional, Taylor, Hugh, additional, Resnikoff, Serge, additional, West, Sheila K, additional, Burton, Matthew J, additional, Aghaji, Ada, additional, Adewole, Adeyemi T, additional, Csutak, Adrienne, additional, Salam, Ahmad Shah, additional, Paduca, Ala, additional, Bron, Alain M, additional, Denniston, Alastair K, additional, Lazo Legua, Alberto, additional, Halim, Aldiana, additional, Tefera, Alemayehu Woldeyes, additional, Mwangi, Alice, additional, Jenkins, Alicia J, additional, Davis, Amanda, additional, Meddeb-Ouertani, Amel, additional, Wali, Amina H, additional, Palis, Ana G, additional, Bastos de Carvalho, Ana, additional, Joshi, Anagha, additional, Kreis, Andreas J, additional, Mueller, Andreas, additional, Bastawrous, Andrew, additional, Cooper, Andrew, additional, Smith, Andrew F, additional, Grzybowski, Andrzej, additional, Arvind, Anitha, additional, Karanu, Anne M, additional, Orlina, Anne O, additional, Burnett, Anthea, additional, Yashadhana, Aryati, additional, Abeydeera, Asela P, additional, Abdurakhmanova, Aselia, additional, Mohamed, Ashik, additional, Bacchav, Ashish, additional, Bernhisel, Ashlie, additional, Webson, Aubrey Walton, additional, Azuara-Blanco, Augusto, additional, Hossain, Ava, additional, Ilhan, Bayazit, additional, Assumpta Lucienne, Bella, additional, Tousignant, Benoit, additional, Shamanna, Bindiganavale R, additional, Wiafe, Boateng, additional, Mueller, Brigitte, additional, Caglar, Cagatay, additional, Mpyet, Caleb, additional, Abraham, Carl H, additional, Cheung, Carol Y, additional, Thiel, Cassandra L, additional, Jan, Catherine L, additional, Emedike, Chike, additional, Chuluunkhuu, Chimgee, additional, Chinyere, Chinomso, additional, Henein, Christin, additional, Gilbert, Clare E, additional, Bascaran, Covadonga, additional, Nitulescu, Cristina Elena, additional, Patel, Daksha, additional, Bachani, Damodar, additional, Kiage, Daniel, additional, Etya'ale, Daniel, additional, Dahdal, David, additional, Woo Lawson, Dawn, additional, Godin, Denise, additional, Nkanga, Dennis G, additional, Ondeyo, Dennis M, additional, O'Brien, Donna, additional, Mutie, Dorothy M, additional, Alalawi, Ebtisam S K, additional, Mayorga, Eduardo, additional, Bin Hashim, Effendy, additional, Ashrafi, Elham, additional, Kishiki, Elizabeth Andrew, additional, Kurian, Elizabeth, additional, D'Esposito, Fabrizio, additional, Masila, Faith, additional, Pena, Fernando Yaacov, additional, Büsch, Fortunat, additional, Topouzis, Fotis, additional, Bandello, Francesco, additional, Oyediji, Funmilayo J, additional, Thumann, Gabriele, additional, Ezz Elarab, Gamal, additional, Kitema, Gatera Fiston, additional, Schlenther, Gerhard, additional, Fefoame, Gertrude Oforiwa, additional, Cochrane, Gillian M, additional, Laganovska, Guna, additional, Awan, Haroon R, additional, Ansari, Harris M, additional, Philippin, Heiko, additional, Burn, Helen, additional, Dimaras, Helen, additional, Filipe, Helena P, additional, Monye, Henrietta I, additional, Kandel, Himal, additional, Randrianarisoa, Hoby Lalaina, additional, Jones, Iain, additional, Murdoch, Ian E, additional, Fabian, Ido Didi, additional, Khan, Imran A, additional, Sharma, Indra P, additional, Elbeih, Islam, additional, Mactaggart, Islay, additional, Pastor, J Carlos, additional, Keunen, Jan E E, additional, Ohuma, Jane A, additional, Pithuwa Nirwoth, Jason, additional, Hammou, Jaouad, additional, Vianna, Jayme R, additional, Biao, Jean-eudes, additional, Burr, Jennifer M, additional, Keenan, Jeremy D, additional, Blijkers, Jess, additional, Black, Joanna M, additional, Barbosa Breda, Joao, additional, Furtado, Joao M, additional, Buchan, John C, additional, Lawrenson, John G, additional, Kempen, John H, additional, Ehrlich, Joshua R, additional, Stern, Judith, additional, Zhang, Justine H, additional, Keskinbora, Kadircan H, additional, Knoll, Karin M, additional, Blanchet, Karl, additional, Schmid, Katrina L, additional, Ono, Koichi, additional, Ogundimu, Kolawole, additional, Balo, Komi, additional, Somda, Kussome Paulin, additional, Yeboah, Kwame, additional, Amissah-Arthur, Kwesi N, additional, Nasehi, Leone, additional, Øverland, Lene, additional, Vijaya, Lingam, additional, Keay, Lisa, additional, Hamm, Lisa M, additional, Mowatt, Lizette, additional, Harrison-Williams, Lloyd C M, additional, Silva, Lucia, additional, Bilotto, Luigi, additional, Mörchen, Manfred, additional, Rabiu, Mansur, additional, Zondervan, Marcia, additional, Chagunda, Margarida, additional, Sandinha, Maria Teresa, additional, Yee Melgar, Mariano, additional, Salas Vargas, Marisela, additional, Daniell, Mark D, additional, Katibeh, Marzieh, additional, Broom, Matt, additional, Collins, Megan E, additional, Alp, Mehmet Numan, additional, Kwarteng, Michael A, additional, Belkin, Michael, additional, Gichangi, Michael, additional, Sylvanowicz, Michelle, additional, Wu, Min, additional, Cano, Miriam R, additional, Shalaby, Mohammad, additional, Duggal, Mona, additional, Khairallah, Moncef, additional, Batur, Muhammed, additional, Bikbov, Mukharram M, additional, Ramappa, Muralidhar, additional, Pamarathi, Nagaraju, additional, Khachatryan, Naira, additional, Muhammad, Nasiru, additional, Kennedy, Neil, additional, Murray, Neil, additional, Beare, Nicholas A V, additional, Astbury, Nick, additional, Carnt, Nicole A, additional, St Rose, Nigel A, additional, Barker, Nigel H, additional, Pehere, Niranjan K, additional, Uche, Nkechinyere J, additional, Lois, Noemi, additional, Awe, Oluwaseun O, additional, Mujica, Oscar J, additional, Okolo, Oteri E, additional, Rani, Padmaja Kumari, additional, Ruamviboonsuk, Paisan, additional, Ndiaye, Papa Amadou, additional, Dhakhwa, Parami, additional, Rozsival, Pavel, additional, Mbulawa, Pearl K, additional, Keane, Pearse A, additional, Jones, Pete R, additional, Holland, Peter, additional, Nukella, Phanindra Babu, additional, Burgess, Philip I, additional, O'Dwyer, Pinar Aydin, additional, Piyasena, Prabhath, additional, Bastola, Pradeep, additional, Morjaria, Priya, additional, Nasimee, Qais, additional, Rambacal, Raizza A T, additional, Das, Rajdeep, additional, Khandekar, Rajiv B, additional, Azad, Rajvardhan, additional, Bashshur, Ramona, additional, Sousa, Raúl A R C, additional, Oenga, Rebecca, additional, Gurung, Reeta, additional, Geneau, Robert, additional, Jacobs, Robert J, additional, Finger, Robert P, additional, Guymer, Robyn H, additional, Sevciuc, Rodica, additional, Khanna, Rohit C, additional, George, Ronnie, additional, Graham, Ronnie, additional, Kawasaki, Ryo, additional, Ho, S May, additional, Mishra, Sailesh Kumar, additional, Buttan, Sandeep, additional, Block, Sandra S, additional, Talero, Sandra, additional, Yoon, Sangchul, additional, Joseph, Sanil, additional, Safi, Sare, additional, Dodson, Sarity, additional, Munoz, Sergio R, additional, Bakayoko, Seydou, additional, Mohammadi, Seyed Farzad, additional, Muez, Shabir Ahmad, additional, Pardhan, Shahina, additional, Hopkins, Shelley, additional, Sheu, Shwu-Jiuan, additional, Coulibaly, Sidi Mohamed, additional, Schellini, Silvana A, additional, Arunga, Simon, additional, Bush, Simon R, additional, Sivaprasad, Sobha, additional, Salomao, Solange R, additional, Marmamula, Srinivas, additional, Onwubiko, Stella N, additional, Misra, Stuti L, additional, Kuyyadiyil, Subeesh, additional, Kulkarni, Sucheta, additional, khanal, Sudarshan, additional, Yasmin, Sumrana, additional, Pavljasevic, Suzana Nikolic, additional, Gilbert, Suzanne S, additional, Braithwaite, Tasanee, additional, Ghidirimschi, Tatiana, additional, Ravilla, Thulasiraj, additional, Fricke, Timothy R, additional, Cogliati, Tiziana, additional, Kassa, Tsehaynesh, additional, Peto, Tunde, additional, Dibb, Ute, additional, Lansingh, Van C, additional, Hu, Victor H, additional, Sheffield, Victoria M, additional, Mathenge, Wanjiku, additional, Dean, William H, additional, Nolan, Winifred, additional, Hiratsuka, Yoshimune, additional, Mahsood, Yousaf Jamal, additional, and Sapkota, Yuddha, additional

Published
2022
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98. Association of Sensory Loss and Knowledge of Heart Attacks

Author

Assi, Lama, Karam, Elsa Salim, Swenor, Bonnielin K., Deal, Jennifer A., Willink, Amber, and Reed, Nicholas S.

Subjects
Adult, Cross-Sectional Studies, Hearing, Myocardial Infarction, Vision Disorders, Humans, Hearing Loss, Article
Abstract

Awareness of heart attack symptoms and the best response is a national public health priority, especially among those at higher risk of heart disease. Adults with sensory loss are more likely to develop heart disease than those without and may be at risk of poor heart attack knowledge owing to limited patient-provider communication and access to health information. The aim of this study is to examine the association between sensory loss and heart attack knowledge.Cross-sectional, nationally representative data from the 2014 and 2017 National Health Interview Survey were used. Analyses were conducted in 2021. Participants aged ≥20 years were included (N=61,168). Being aware of heart attack symptoms and the best response was considered as recognizing the 5 examined symptoms of heart attacks and the proper emergency response, as defined in the Healthy People 2020 objectives. Functional hearing and vision losses were defined as self-reported difficulty in hearing and seeing.Overall, 16.2% reported functional hearing loss, and 10.1% reported vision loss. Having vision loss was associated with a lack of knowledge of heart attacks symptoms or the best response (prevalence ratio=1.08, 95% CI=1.06, 1.11). In a separate model, having vision loss only and dual sensory loss (concurrent vision and hearing loss) were associated with not having this knowledge (prevalence ratio=1.09, 95% CI=1.06, 1.12 and PR=1.08, 95% CI=1.01, 1.15, respectively), but having hearing loss only was not (prevalence ratio=1.03, 95% CI=0.99, 1.06).Non-institutionalized adults with sensory loss may represent a group to target for improving the knowledge of heart attacks in the population.

Published
2021

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