Characteristics of discrepancies between self-reported visual function andmeasured reading speed

PURPOSE. Visual impairment is a risk factor for morbidity in the elderly an d is often screened for by self-report. This study evaluates whether there are subsets for whom there is a discrepancy between self-reported and measu red function. METHODS. The prevalence of a discrepancy between self-reported difficulty r eading a newspaper and measured reading speed was determined in 2520 commun ity-based men and women, aged 65 to 84 years, and the discrepant group char acterized by polychotomous regression. RESULTS. Of subjects who reported minimal difficulty reading a newspaper, 1 0.8% (227/2107) read newsprint-sized text (0.21 degrees) more slowly than 8 0 words/min, a level previously shown to be necessary for sustained reading . Poor visual acuity, presence of psychiatric symptoms, and less satisfacti on with vision were associated with being in the group that read slowly and reported difficulty with reading. Better cognition, better visual acuity, more years of education, white race, and fewer psychiatric symptoms were as sociated with being in the group that read more quickly and reported minima l difficulty. When reading the text size at which subjects read their faste st, only 2.6% of those with minimal difficulty remained discrepant. These i ndividuals were more likely to have less education, be male, be African Ame rican, and have poorer cognitive status than those who did not remain discr epant. CONCLUSIONS. A subset of the elderly population have a substantial discrepa ncy between self-reported reading difficulty and measured reading speed. In some, this discrepancy may be based on underlying expectations and experie nces, and in others it may represent a transition from no visual impairment to visual impairment.