Visual impairment and perceived discrimination in older adults

By Bianca Nogrady
Older adults with impaired vision perceive themselves to be at increased risk of discrimination, and this can negatively impact their quality of life, research published in JAMA Ophthalmology suggests.

Researchers collected self-reported data from 7677 individuals aged 50 years and older, from the English Longitudinal Study of Ageing, about their level of vision impairment and perceived discrimination. They also assessed depressive symptoms, life satisfaction, quality of life and loneliness using a variety of validated scales.

Overall, 11.9% of the participants reported poor eyesight generally – about half of whom reported a history of eye disease – and 8.6% reported poor eyesight up close. Individuals reporting poor eyesight were more likely to be older, female, non-white, unmarried and from the lowest wealth quintiles.

Individuals with poor eyesight were 41% more likely to report any discrimination than those with good eyesight. About one-third of participants with poor eyesight felt that they were treated with less respect or courtesy, one-quarter felt that people believed they were ‘not clever’ and almost one in 10 reported being threatened or harassed.

Those who reported poor eyesight and discrimination were more than twice as likely to have depressive symptoms and be lonely, and reported having lower quality of life, than individuals with poor eyesight who did not experience discrimination.

‘This finding suggests that higher levels of discrimination may contribute to previously reported associations between visual impairment and increased loneliness, social exclusion and reduced social contact, lower QOL, and life dissatisfaction,’ the study authors wrote.

Commenting on the findings, retinal specialist Dr Grant Raymond, Head of the Medical Retina Service at Royal Adelaide Hospital said that the findings were a ‘soft signal’ of something that had long been suspected was the case.

However, Dr Raymond, also President of the Royal Society for the Blind, highlighted that the study relied heavily on participant self-report for both visual impairment and experience of discrimination, and it was also difficult to tease out the effect of socioeconomic status.

‘The group who is less likely to be purchasing glasses, for example, are probably the poorer elderly,’ Dr Raymond told Medicine Today. ‘And we know from experience that people suffer social isolation with visual impairment.’
JAMA Ophthalmol 2019; doi: 10.1001/jamaophthalmol.2019.1230.