Visual impairment and quality of life among older adults: An examination of explanations for the relationship

Objectives. We examine 4 potential explanations for the lower quality of life reported by older adults with greater visual impairment. Methods. Using 2 waves of data from a nationally representative sample of older persons (a subsample of the Americans' Changing Lives Study, 1986 and 1989), we run residual change regression analysis to assess the extent to which the effect of visual impairment on quality of life, indicated by depressive symptoms and life satisfaction, is explained by changes in each of the following: (1) activity limitations; (2) socioeconomic resources, measured as income and financial strain; (3) social resources, indicated by social integration and perceived support; and (4) psychological resources, measured by self-efficacy. Results. Higher levels of visual impairment are associated with more depressive symptoms and lower life satisfaction over the 3-year period. Each hypothesized mediator plays a role in explaining the effect of visual impairment on declines in quality of life; however, the strongest mediating effects are found for self-efficacy. Discussion. By identifying multiple pathways through which visual impairment diminishes quality of life among older adults, this study highlights the importance of multipronged intervention efforts.