Abstract

BackgroundThe number of older adults with vision impairment (VI) is growing. As health care services increasingly call for patients to use technology, it is important to examine internet/health information technology (HIT) use among older adults with VI.ObjectiveThis study aimed to examine (1) the rates of internet/HIT use among older adults with VI compared with a matched sample of their peers without VI, (2) associations of VI with internet/HIT use, and (3) association of HIT use with psychological distress, assessed with the Kessler-6 screen.MethodsData were obtained from the 2013 to 2018 US National Health Interview Survey. Older adults (aged ≥65 years) with self-reported VI were matched with older adults without VI, in a 1:1 ratio, based on age, sex, number of chronic medical conditions, and functional limitations (N=2866). Descriptive statistics and multivariable logistic regression models, with sociodemographic factors, health conditions, health insurance type, and health care service use as covariates, were used to examine the research questions.ResultsIn total, 3.28% of older adults (compared with 0.84% of those aged 18-64 years) reported VI, and 25.7% of them were aged ≥85 years. Those with VI were significantly more socioeconomically disadvantaged than those without VI and less likely to use the internet (adjusted odds ratio [aOR] 0.64, 95% CI0.49-0.83) and HIT (aOR 0.74, 95% CI 0.56-0.97). However, among internet users, VI was not associated with HIT use. HIT use was associated with lower odds of mild/moderate or serious psychological distress (aOR 0.62, 95% CI 0.43-0.90), whereas VI was associated with greater odds of mild/moderate or serious distress (aOR 1.84, 95% CI 1.36-2.49). Health care provider contacts were also associated with higher odds of internet or HIT use.ConclusionsCompared with their matched age peers without VI, older adults with VI are less likely to use HIT because they are less likely to use the internet. Socioeconomically disadvantaged older adults experiencing a digital divide need help to access information and communication technologies through a fee waiver or subsidy to cover internet equipment and subscription and ensure continuous connectivity. Older adults with VI who do not know how to use the internet/HIT but want to learn should be provided instruction, with special attention to accessibility features and adaptive devices. Older adults with a low income also need better access to preventive eye care and treatment of VI as well as other health care services.

Highlights

  • BackgroundA significant portion of older adults in the United States have vision impairment (VI) and associated disability

  • Among internet users, VI was not associated with health information technology (HIT) use

  • HIT use was associated with lower odds of mild/moderate or serious psychological distress, whereas VI was associated with greater odds of mild/moderate or serious distress

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Summary

Introduction

BackgroundA significant portion of older adults in the United States have vision impairment (VI) and associated disability. According to the 2014 American Community Survey, 4.3% (1.1 million) of the civilian, noninstitutionalized population of adults aged 65 to 74 years and 10% (1.9 million) of those aged ≥75 years reported blindness or serious trouble seeing, even when wearing glasses [1]. In the 2014 National Health Interview Survey (NHIS), 13.5% (6.1 million noninstitutionalized adult participants aged ≥65 years, including 350,000 who were blind) reported “any trouble seeing, even when wearing glasses or contact lenses” [1]. The Centers for Disease Control and Prevention’s (CDC) analysis of the 2016 Behavioral Risk Factor Surveillance System (BRFSS) data found that 6.6% of noninstitutionalized older adults reported having a vision-related disability, compared with 2.7% in the 18 to age group and 6.1% in the to 64 age group [2]. As health care services increasingly call for patients to use technology, it is important to examine internet/health information technology (HIT) use among older adults with VI

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