Vision in the elderly and its use in the social environment.

A randomized sample of 601 subjects aged 65 or over were examined for their visual function and their use of vision in daily life. The participation percentage was 91% and constant throughout all age groups, and the population sample studied is considered to be representative of the population of the city of Turku in Finland. The best corrected visual acuity was found to be good (0.8 or 0.7/0.3) in 73%, with a gradual decline with age to 20% in late senescence (85 years or over). The poorest acuity level of less than 0.1 was found in 1% of the entire study population and in 7% of those aged 85 or over. 91% of the subjects were found to be capable of reading newspaper-size print by using conventional presbyopic lenses. For those aged 85 years or over the rate was 50%. When also using low vision aids for maximal optical correction, the rate rose to 93% of the entire study population, and to 57% of those aged 85 or over. The functional visual acuity, i.e. the level of vision actually used in daily life, was clearly inferior with only 56% of the entire study population and 13% of those aged 85 or over possessing good visual acuity. Other acuity levels showed the same rations. Senile macular degeneration and cataract were found to be the commonest causes of visual impairment in the elderly. Poor sight could be considered a prime contributory factor for being in institutional accommodation in 11% of the cases. Visually impaired persons were clearly more dependent on home help as compared with the elderly population in general. A majority (over 90%) of elderly people in all age groups were found to be interested in resolution-requiring activities (reading, TV, needlework, driving, etc.). In other everyday activities, the demands on vision were found to be lower, an acuity level of 0.2-0.15 not yet being restrictive. This is suggested to be dependent on the predominance of lower spatial frequencies when seeing in everyday environments. Intolerance of optic correction by means of spectacle lens was found in 18% of the aphakics. As regards moderate-power lenses, one third of elderly persons were found to reject glasses for traveling. 57% of those who rejected glasses considered themselves unmotivated to wear glasses in everyday life, 35% blamed adaptation difficulties. Subjects aged 75 years or over who suffered from impoverished mobility or dizziness were particularly reluctant to wear glasses when moving about.(ABSTRACT TRUNCATED AT 400 WORDS)