Articles about Eye Health and Disease 2002
 

Self-management of Age-Related Macular Degeneration and Quality of Life

(From Brody BL, et al, Arch Ophthalmol. 2002;120:1477-1483)

Age related macular degeneration (AMD) is a common cause of visual loss in United States, typically in the elderly.  The loss of central vision makes daily activities of living such as reading, dressing, eating, etc. difficult, and often can lead to symptoms depression.  This  study looked at the effectiveness of an age-related macular degeneration  self-management program, consisting of health education and enhancement of problem-solving skills, to improve quality of life as shown by measures of mood and function.

In this study, two hundred thirty-one community-dwelling cognitively intact volunteers (mean age, 80.6 years) with advanced macular degeneration were randomly assigned to a 12-hour self-management program (86 participants), a series of 12 hours of tape-recorded health lectures (74 participants), or to a waiting list (72 participants).

The primary outcome measure was emotional distress (Profile of Mood States). Secondary outcome measures included function (National Eye Institute Visual Function Questionnaire), social support (Duke Social Support Index), outlook on life (Life Optimism Test–Revised), and self-confidence to handle AMD-specific challenges in daily life (AMD Self-Efficacy Questionnaire). Clinical depression was determined in accord with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Axis I, Fourth Edition, Research Version.

Results:  The self-management group showed significant improvement in measures of mood and function compared with controls (those on the waiting list). These changes were significantly greater for the depressed than for the non-depressed subjects. Decreased emotional distress was associated with increased self-efficacy and functioning, while improvements in function were associated with increases in self-efficacy and perceived social support.

Conclusions  These findings suggest that the AMD self-management program was an effective intervention to enhance well-being in older persons with poor eyesight due to AMD, particularly in those who were initially depressed.

 

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