THE PSYCHOSOCIAL IMPACT OF MACULAR DEGENERATION

Background: Age-related macular degeneration (AMD), the leading cause of irreversible blindness and low vision among the elderly, has not be en well studied with regard to its impact on daily life. This study wa s designed to demonstrate the impact of AMD on quality of life, emotio nal distress, and functional level. Participants: The study sample con sisted of 86 elderly adults (average age, 79 years) with AMD who were legally blind in at least 1 eye. Participants completed a battery of m easures that included the Quality of Well-being Scale, the Instrumenta l Activities of Daily Living index, self-rated general health status, and the Profile of Mood States. Results: Persons with AMD experienced significant reductions in key aspects of daily life. Their ratings for quality of life (average Quality of Well-being Scale score=0.581) and emotional distress (average Profile of Mood States total score=65.36) were significantly worse than those for similarly aged community adul ts and were comparable with those reported by people with chronic illn esses (eg, arthritis, chronic obstructive pulmonary disease, acquired immunodeficiency syndrome, and bone marrow transplants). Patients with AMD were also more likely than a national sample of elderly individua ls to need help with daily activities. Visual acuity was related to ab ility to carry out daily activities (Instrumental Activities of Daily Living, r=0.28, P=.008). Quality of life ratings were significantly re lated to the ability to carry out daily activities (r=-0.38, P=.001), self-rated general health status (r=-0.21, P=.05), and emotional distr ess (Profile of Mood States total score, r=-0.25, P=.02). Individuals with a shorter period of perceived vision loss were more likely to rep ort high levels of emotional distress (r=-0.24, P=.03) than those with a longer period of perceived vision loss. Further, those who were bli nd in 1 eye were even more significantly distressed than those who wer e blind in both eyes. Conclusions: Elderly persons with AMD causing le gal blindness in 1 or both eyes have significant emotional distress an d profoundly reduced quality of life and need help with key daily acti vities.