The association between vision impairment and social participation in community-dwelling adults: a systematic review

Abstract

Vision impairment (VI) is an important contributor to the global burden of disability and is associated with decreased well-being. Recent research has attempted to devise a conceptual framework to explain the health consequences of VI. One proposed mechanism by which VI leads to declines in well-being and other adverse health and disability outcomes is through limitations in social participation (SP). SP is an integral component of overall functioning, optimal aging, and well-being, and reductions in SP are associated with lower health-related quality of life. The purpose of this systematic review was to appraise the existing literature on the relationship between VI and SP. The protocol for this review was registered on PROSPERO (CRD42018102767) and adhered to PRISMA guidelines. A comprehensive search of five databases (MEDLINE, EMBASE, PsycINFO, Scopus, Sociology Database) yielded 881 unique studies, of which 19 met inclusion criteria. Among the 19 included studies, 18 concluded that VI was associated with reduced SP and one reported mixed results. Bias was assessed using the Effective Public Health Practice Project Quality Assessment. In the quality assessment, four studies were rated “moderate” and fifteen were rated “weak.” There was wide variation in study populations and measurement of VI and SP. In conclusion, there is consensus that VI is associated with reduced SP. However, more rigorous study design and better standardization in the assessment of VI and SP could facilitate valid comparisons across populations, diseases, and levels of VI. Attempts to provide vision rehabilitation and mitigate the effects of VI on overall health and well-being might consider strategies to improve SP.

摘要

视力损伤 (VI) 是造成全球残疾负担的重要因素并且与人的幸福感降低有关。近期的一项研究设计了一个概念框架来说明VI对健康的影响。其中一个可能的机制是, VI导致幸福感降低的机制之一是参与社会活动受限。社会参与度是组成整体功能, 最佳老龄状态和幸福感的一部分, 社会参与度减少与健康的生活质量下降有关。本篇系统回顾旨在评价已发表的关于VI与社会参与度相关性的文章。本篇系统综述的实施方案登记在PROSPERO (CRD42018102767), 并且遵照PRISMA指南。对五个数据库(MEDLINE, EMBASE, PsycINFO, Scopus, Sociology Database)进行系统文献检索, 共涵盖881个不同的研究, 其中19篇符合入选标准。在这19篇入选文章中, 18篇的结论是VI与社会参与度下降有关, 1篇文章的结论不明确。是否存在偏倚采用EPHPPQA方法进行评估。在文章质量评估中, 4篇文章被评为“可信度中等”, 15篇文章被评为“可信度低”。这些文章在VI和社会参与度的调查人群和研究方法上都存在较大差异。总体而言, VI与社会参与度下降具有相关性已达成共识。然而, 在评估AI与社会参与度的相关性时, 更严格的实验设计, 更好的评价标准可以促进研究在不同的人群, 疾病和VI分级中做有效的比较。尝试提供视力康复并减轻VI对幸福感的影响, 可以考虑改善SP的策略。

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Funding

This work was supported by grants from the National Eye Institute (K23 EY027848) to JRE; a pilot grant from the Michigan Center on the Demography of Aging at the University of Michigan funded through a National Institute on Aging core grant (P30 AG012846); an unrestricted grant from Research to Prevent Blindness to the Department of Ophthalmology and Visual Sciences at the University of Michigan; and the Lighthouse Guild.

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Correspondence to Joshua R. Ehrlich.

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Shah, K., Frank, C.R. & Ehrlich, J.R. The association between vision impairment and social participation in community-dwelling adults: a systematic review. Eye 34, 290–298 (2020). https://doi.org/10.1038/s41433-019-0712-8

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