Assessing Older Adults' Functional Visual Performance Using the Performance Quality Rating Scale.

Visual impairment has distinct impacts on the activities of older adults. Quantifying the functional impact of visual loss would facilitate targeted rehabilitation. The objectives of this study were to: (1) develop an observational assessment of the functional visual performance of older adults using the Performance Quality Rating Scale (PQRS); (2) test the feasibility and inter-rater agreement in a pilot sample of older adults with visual impairment. A convenience sample of older adults with vision loss (N = 20) performed seven pre-selected activities. Performance was videoed (N = 126 videos) and rated by two raters using specific operational definitions. All participants completed the seven activities with the given resources and 90% of videos were successfully rated using the developed PQRS. Inter-rater agreement was substantial (weighted Kappa = 0.71; 95% confidence interval [CI] = [0.64, 0.79]) for all activities. The developed PQRS for functional vision is feasible, with substantial inter-rater agreement, to assess functional vision of older adults in an outpatient setting.

Assessing older adults' use of vision using the Performance Quality Rating Scale.Visual impairment has different impacts on the everyday activities of older adults. Assessing the specific impact would help therapists to provide rehabilitation targeting their daily challenges. The objectives of this study were (1) to develop an assessment of how older adults use their vision using the Performance Quality Rating Scale (PQRS); (2) to test the possibility of using, and the agreement of using this tool between two raters in a pilot sample. Twenty older adults with vision loss performed seven activities in an outpatient clinic. In total, 126 videos of their performances were rated by two raters using the PQRS. 90% of the videos were successfully rated using the developed PQRS with good agreement between the raters. The developed PQRS can possibly be used to assess how older adults use their vision for daily activities in an outpatient setting.

The impact of low vision on activities, participation, and goals among older adults: a scoping review.

PURPOSE: Participation is a key outcome of rehabilitation. However, no reviews have investigated the impact of low vision on the activities, participation, and goals of older adults. This paper aims to review and synthesize available literature on how low vision impacts the activity and participation of older adults. METHOD: A scoping review was conducted. The key findings were extracted from 30 full-text articles that met the selection criteria. The International Classification of Functioning, Disability and Health was used to frame the findings at the activity and participation levels. RESULTS: At the activity level, the categories of Walking, Moving around in different locations, and Reading were commonly impacted by low vision. The main domains impacted at the participation level were Community, social and civic life and Interpersonal interaction and relationships. Only one study addressed the goals of older adults with low vision. CONCLUSION: Low vision impacts reading, walking, and moving around in different locations. Rehabilitation therapists should be aware of and consider assessing these activities. Further research is needed on the impact of low vision on other functional activities, participation, and self-identified goals of older adults to guide clinical practice.Implications for rehabilitationLow vision has an impact on the activity level of older adults, consistently identified in the areas of walking and moving around in different locations and reading for knowledge and leisure.At the participation level, the impact of low vision is less frequently identified compared to the areas identified at the activity level, in the areas of leisure, social interactions and basic and instrumental ADL.Rehabilitation therapists working with older adults with low vision should assess clients' performance of moving around in different locations, in addition to walking, and include screening questions on the impact of low vision on driving.Rehabilitation therapists working with older adults with low vision should determine clients' reading needs and acquire competence in assessing clients' reading ability and providing intervention for different types of reading to enable them to continue participating in various life situations that require the performance of reading.

Classifying Types of Visual Loss Linked With Function to Inform Referral to Vision Rehabilitation for Older Adults in Singapore.

Objective: Visual impairment restricts performance in activities of daily living. The aim of this study was to classify types of visual loss associated with function in older adults based on clinical data and World Health Organization (WHO) acuity and visual field criteria. Methods: Seven hundred retrospective medical records of older adults seen at the outpatient ophthalmology clinics of a Singapore hospital were reviewed. Extracted data was mapped to the WHO low vision criteria. A flow chart was developed to classify the main types of visual loss aligned with function. Results: The flow chart developed describes four major types of visual loss: (1) full visual field with decreased visual acuity, (2) any visual field loss with greater than ten degrees of available field, (3) peripheral field loss with less than 10° of available field, and (4) any visual field loss due to a cortical event. Within each major type, sub-categories were identified reflecting the complexity of the visual impact of the eye conditions. Conclusion: The flow chart can be applied to outpatient records to identify older adults with different types of visual loss to inform targeted rehabilitation linked with function.

Health Promotion Board-Ministry of Health Clinical Practice Guidelines: Falls Prevention among Older Adults Living in the Community.

The Health Promotion Board (HPB) has developed the Clinical Practice Guidelines (CPG) on Falls Prevention among Older Adults Living in the Community to provide health professionals in Singapore with recommendations for evidence-based assessments and interventions for falls prevention. This article reproduces the introduction and executive summary of the key recommendations from the HPB-MOH CPG on Falls Prevention among Older Adults Living in the Community for the information of SMJ readers. The chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Health Promotion Board website: http://www.hpb.gov. sg/cpg-falls-prevention. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.