Association of visual impairment with disability: a population-based study

Objective To determine the relationship between visual impairment and other disabilities in a developing country. Methods In this cross-sectional ancillary study, all individuals 50 years and older in 18 communities in the Chitwan region of Nepal were administered visual acuity screening and the Washington Group Short Set (WGSS) of questions on disability. The WGSS elicits a 4-level response for six disability domains: vision, hearing, walking/climbing, memory/concentration, washing/dressing, and communication. The association between visual impairment and disability was assessed with age- and sex-adjusted logistic regression models. Results Overall, 4719 of 4726 individuals successfully completed visual acuity and disability screening. Median age of participants was 61 years (interquartile range: 55–69 years), and 2449 (51.9%) were female. Participants with vision worse than 6/60 in the better-seeing eye were significantly more likely to be classified as having a disability in vision (OR 18.4, 95% CI 9.9–33.5), walking (OR 5.3, 95% CI 2.9–9.1), washing (OR 9.4, 95% CI 4.0–21.1), and communication (OR 5.0, 95% CI 1.7–13.0), but not in hearing (OR 0.6, 95% CI 0.006–2.2) or memory (OR 2.2, 95% CI 0.7–5.1). Conclusions Visually impaired participants were more likely to self-report disabilities, though causality could not be ascertained. Public health programs designed to reduce visual impairment could use the WGSS to determine unintended benefits of their interventions.