Wahl H W, Heyl V, Oswald F, Winkler U
Deutsches Zentrum für Alternsforschung an der Universität Heidelberg.
Ophthalmologe. 1998 Jun;95(6):389-99. doi: 10.1007/s003470050286.
Epidemiologic studies have provided clear evidence that the majority of people affected by severe visual impairment are adults above the age of 60 years. The goal of this psychological research was to analyze the emotional and behavioral consequences of age-related visual impairment in three steps: descriptive data concerned with subjective well-being, depression, everyday competence, and leisure as well as explanations of interindividual variability based on individual and environmental variables are presented (study I). Also, the impact of the time of onset (early versus late in life) is addressed (study II). Finally, the role of the living accomodation (institutional versus private household) was the main target of another study (study III).
Study I was based on 84 elderly adults who experienced an irreversible visual loss after age 55 years; a control group of unimpaired elderly adults is also included (mean age 75.8, range 59 to 92). In study II, 18 elderly adults who had been blind since their early childhood were compared to nine matched elderly adults who experienced blindness in their later life as well as nine matched unimpaired elderly adults (mean age 71.7, range 63 to 83). The data for study III came from 15 visually impaired institutional residents who were compared to 15 matched unimpaired residents and 15 matched visually impaired and 15 unimpaired older adults living in private households (mean age 87.0, range 78 to 93). All subjects underwent an intensive psychological measurement program.
The findings of study I emphasize that age-related visual impairment is associated with lower subjective well-being, greater depression, reduced everyday competence, and lowered leisure activity level. A significant portion of interindividual variability in these outcomes can be explained by addressing individual variables (e.g., comorbidity) as well as environmental variables (e.g., quality of the dwelling unit). Study II data offer evidence that older adults suffering from blindness since their early childhood are better adapted than older adults who experienced blindness only in their later years. Study III shows that visually impaired institutional residents reveal deficits in everyday competence and social contacts as contrasted with their unimpaired counterparts, whereas no difference is observed in the domain of subjective well-being.
All three studies point to the negative impact of age-related visual impairment on emotional and behavioral adaptation in later life. This highlights the need for a whole range of rehabilitative efforts, including psychosocial elements, which are described in the final part of this article.
流行病学研究已提供明确证据，表明受严重视力损害影响的大多数人是60岁以上的成年人。这项心理学研究的目的是分三个步骤分析与年龄相关的视力损害所带来的情绪和行为后果：呈现与主观幸福感、抑郁、日常能力和休闲相关的描述性数据，以及基于个体和环境变量对个体间差异的解释（研究I）。此外，还探讨了发病时间（生命早期与晚期）的影响（研究II）。最后，居住环境（机构照料与私人家庭）的作用是另一项研究的主要目标（研究III）。
研究I基于84名55岁以后经历不可逆视力丧失的老年人；还纳入了一组未受损的老年对照组（平均年龄75.8岁，范围59至92岁）。在研究II中，将18名自幼失明的老年人与9名年龄匹配的晚年失明的老年人以及9名年龄匹配的未受损老年人进行比较（平均年龄71.7岁，范围63至83岁）。研究III的数据来自15名视力受损的机构居住者，将他们与15名年龄匹配的未受损居住者以及15名年龄匹配的视力受损和15名未受损的私人家庭居住的老年人进行比较（平均年龄87.0岁，范围78至93岁）。所有受试者都接受了全面的心理测量程序。
研究I的结果强调，与年龄相关的视力损害与较低的主观幸福感、更严重的抑郁、日常能力下降和休闲活动水平降低有关。这些结果中很大一部分个体间差异可以通过考虑个体变量（如合并症）以及环境变量（如居住单元质量）来解释。研究II的数据表明，自幼失明的老年人比仅在晚年失明的老年人适应性更好。研究III表明，与未受损的同龄人相比，视力受损的机构居住者在日常能力和社交方面存在缺陷，而在主观幸福感方面未观察到差异。
所有三项研究都指出了与年龄相关的视力损害对晚年情绪和行为适应的负面影响。这突出了进行一系列康复努力的必要性，包括本文最后部分所述的心理社会因素。
