Vision Impairment and Activities of Daily Living Disability among Older Mexican Americans: Nativity Differences

Research Objectives To examine vision impairment (VI) as predictor of activities of daily living (ADL) disability over time among older Mexican Americans who were non-disabled at baseline and to determine whether this relationship was moderated by nativity status. Design Longitudinal survey of 18 years follow-up. Setting Community-dwelling setting. Participants 1,316 non-institutionalized Mexican Americans aged 70 years and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1998-2016) residing in Arizona, California, Colorado, New Mexico, and Texas. Interventions N/A. Main Outcome Measures The primary outcome variable was ADL disability and was defined as difficulty in performing one or more of the seven ADL activities (eating, dressing, bathing, grooming, transferring, walking, or toileting). The primary independent variable was self-reported VI and was defined as difficulty in recognizing a friend across at arm's length's away the street, across the room, or across the street. Covariates included socio-demographics, comorbidities, body mass index, Mini Mental State Exam (MMSE), depressive symptoms, smoking status, and hearing impairment. Generalized estimating equation models were performed to estimate the odds ratios (OR) and 95% Confidence Interval (CI) of ADL disability over time as a function of self-reported VI. Results Participants with ADL disability compared to those without ADL disability at baseline were significantly more likely to report VI (26.63% vs. 11.93%). Over time participants with VI had greater odds ratio of ADL disability (OR=1.32, CI=1.01-1.72) than those without VI after controlling for all covariates. Those with VI and being foreign born had increased odds of ADL disability (OR=1.78, CI 1.24-2.59) than those with VI and being United States born (OR=0.94, CI 0.64-1.39). Conclusions Older Mexican Americans with VI were at increased odds of developing ADL disability over time, and this relationship was moderated by nativity status. Addressing vision health disparities by health care providers will reduce ADL disability and increase independence. Author(s) Disclosures None.