@Article{info:doi/10.2196/58729,
author="Takesue, Atsuhide
and Hiratsuka, Yoshimune
and Kondo, Katsunori
and Aida, Jun
and Nakagomi, Atsushi
and Nakao, Shintaro",
title="Association Between Visual Impairment and Daily Internet Use Among Older Japanese Individuals: Cross-Sectional Questionnaire Study",
journal="JMIR Form Res",
year="2024",
month="Dec",
day="9",
volume="8",
pages="e58729",
keywords="visual impairment",
keywords="visually impaired",
keywords="internet",
keywords="internet use",
keywords="internet usage",
keywords="older adults",
keywords="digital divide",
keywords="telemedicine",
keywords="mobile phone",
abstract="Background: Older adults might not use computers due to psychological barriers, environmental barriers such as not owning a computer or lack of internet access, and health-related barriers such as difficulties with fine motor skills, low cognitive function, or low vision. Given the health benefits of internet use among older adults, inadequate use of the internet is an urgent public health issue in many countries. Objective: We aimed to determine whether visual impairment is associated with internet use in a population-based sample of older adults. Methods: This cross-sectional study sourced data for the year 2016 from the Japan Gerontological Evaluation Study. It included functionally independent community-dwelling individuals aged ?65 years (N=19,452) in Japan. The respondents reported their visual status by answering the question, ``Is your eyesight (without or with usual glasses or corrective lenses) excellent, very good, good, fair, or poor?'' We defined ``internet user'' as a person who uses the internet ``almost daily.'' We used multivariate logistic regression with multiple imputations to analyze visual status, daily internet use, and any correlations between them. Results: We observed that 23.6\% (4599/19,452) of respondents used the internet almost daily. Respondents with good visual status notably tended to use the internet more frequently than those with poor visual status. Specifically, 13\% and 31\% of respondents with poor and excellent vision, respectively, used the internet almost daily. In contrast, 66\% and 45\% of respondents with poor and excellent vision, respectively, did not use the internet. Even after adjusting for several covariates (age, sex, equivalized income, years of education, marital status, depression, history of systemic comorbidities, frequency of meeting friends, and total social participation score), significant associations persisted between visual status and daily internet usage. The odds ratios (ORs) tended to increase as visual status improved (P for trend <.001). The adjusted ORs for individuals with excellent and very good visual status who used the internet almost daily were 1.38 (95\% CI 1.22-1.56) and 1.25 (95\% CI 1.15-1.36), respectively. Conversely, the adjusted OR for those with fair or poor visual status was 0.73 (95\% CI 0.62-0.86). Conclusions: In this study, we reaffirmed what several previous studies have pointed out using a very large dataset; visual impairment negatively impacted daily internet use by older adults. This highlights the need to address visual impairments to promote web use as health care services become more easily accessed on the web. ",
doi="10.2196/58729",
url="https://formative.jmir.org/2024/1/e58729"
}


@Article{info:doi/10.2196/57168,
author="Kim, Yonghwan
and Kim, Jeongsook
and Seo, Jong Eoi
and Kim, Tae Kyung
and Lee, Jae-woo
and Kim, Joungyoun
and Kang, Hee-Taik",
title="Association Between Fatty Liver Index and Incidence of Cataract Surgery in Individuals Aged 50 Years and Older Based on the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) Data: Longitudinal Retrospective Cohort Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Nov",
day="14",
volume="10",
pages="e57168",
keywords="fatty liver index",
keywords="nonalcoholic fatty liver disease",
keywords="all-cataract",
keywords="senile-cataract",
keywords="surgery",
keywords="NAFLD",
keywords="Korean National Health Insurance Service",
keywords="Health Screening Cohort",
keywords="NHIS-HEALS",
abstract="Background: Cataract is a leading cause of vision impairment. Obesity-related risk factors, including insulin resistance, increase the risk of cataract. The fatty liver index (FLI) is a biomarker for noninvasive fat layer prediction of nonalcoholic fatty liver disease. The FLI has been used to evaluate the metabolic contribution in other organs besides the eye. However, no study exists on the FLI and eye disease. Objective: This retrospective cohort study for the association between the FLI and incidence of cataract surgery in individuals older than 50 years was designed to show that a higher FLI is associated with an increased incidence of cataract surgery in individuals aged 50 years and older. Methods: This study was retrospectively designed based on the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) cohort (median follow-up of 9.8 years). Participants were assigned to 1 of 3 groups based on the FLI: low (FLI<30), intermediate (FLI 30-59), or high (FLI?60). Kaplan-Meier survival analysis was performed on the cumulative incidence of all-cataract and senile-cataract surgery. Multivariable Cox proportional hazards regression models were used to study the association between the FLI group and cataract surgery after adjusting for potential confounders. Results: Of the 138,347 included participants, the incidence of cataract surgery was 12.49\% (4779/38,274), 13.95\% (6680/47,875), and 14.16\% (7496/52,930) in the low, intermediate, and high FLI groups, respectively. After adjusting for all confounding factors, hazard ratios (HRs; 95\% CIs) in the high FLI group for all-cataract surgery were 1.111 (1.028?1.199) and 1.184 (1.101?1.274) in men and women, respectively, when compared with the low FLI group. HRs (95\% CIs) in the high FLI group for senile-cataract surgery were 1.106 (1.022?1.197) and 1.147 (1.065?1.237) in men and women, respectively, when compared with the low FLI group. The project was conducted between August 2023 and February 2024 without donations from external bodies. Conclusions: Individuals with a higher FLI had a higher risk of all-cataract surgery. This association was maintained even after limiting the analyses to senile-cataract surgery. ",
doi="10.2196/57168",
url="https://publichealth.jmir.org/2024/1/e57168"
}


@Article{info:doi/10.2196/53370,
author="Sood, Ishaana
and Sabherwal, Shalinder
and Mathur, Umang
and Jain, Elesh
and Bhadauria, Madhu
and Agrawal, Deepshikha
and Khurana, Ashi
and Mittal, Vikas
and Mahindrakar, Avinash
and Govindahari, Vishal
and Kulkarni, Sucheta
and Nischal, K. Ken",
title="Harnessing Generalizable Real-World Ophthalmic Big Data: Descriptive Analysis of the Bodhya Eye Consortium Model for Collaborative Research",
journal="Online J Public Health Inform",
year="2024",
month="Sep",
day="30",
volume="16",
pages="e53370",
keywords="anthropological and genomic heterogeneity",
keywords="big data",
keywords="consortium",
keywords="collaborative research",
keywords="generalizability",
keywords="global health impact",
keywords="North India",
abstract="Background: Eye care organizations and professionals worldwide are increasingly focusing on bridging the gap between population health and medical practice. Recent advances in genomics and anthropology have revealed that most Indian groups trace their ancestry to a blend of 2 genetically distinct populations: Ancestral North Indians, who share genetic affinities with Central Asians, Middle Easterners, Caucasians, and Europeans; and Ancestral South Indians, genetically distinct from groups outside the Indian subcontinent. Studies conducted among North Indian populations can therefore offer insights that are potentially applicable to these diverse global populations, underscoring significant implications for global health. Objective: The Bodhya Eye Consortium is a collaboration among 8 high-volume nonprofit eyecare organizations from across North India. The consortium aims to harness real-world data consistently and with assured quality for collaborative research. This paper outlines the formation of the consortium as a proposed model for controlled collaborative research among the leading eyecare organizations of North India. Methods: We detail the creation and effective implementation of a consortium following a structured road map that included planning and assessment, establishing an exploratory task force, defining specialty areas, setting objectives and priorities, and conducting a SWOT (strengths, weaknesses, opportunities, and threats) analysis. Central to this process was a comprehensive data audit aimed at standardizing data collection across all participating organizations. Results: The consortium currently comprises 9 organizations, each represented in the governance structure by the Governing Council. Scientific standards for published research are established and overseen by the Scientific Committee, while the Conflict Resolution Committee manages any unresolved disputes. The consortium's working groups, organized by various eyecare specialties, collaborate on research projects through virtual interactions. A foundational step in this process was the organizationwide data audit, which revealed that most organizations complied with accurate and standardized data collection practices. Organizations with deficiencies in data completeness developed action plans to address them. Subsequently, the consortium adopted data collection proformas, contributing to the publication of high-quality manuscripts characterized by low dropout rates. Conclusions: The collaborative research conducted by the Bodhya Eye Consortium---a group of high-volume eyecare organizations primarily from North India---offers a unique opportunity to contribute to scientific knowledge across various domains of eyecare. By leveraging the established heterogeneity of anthropological and genomic origins within the population, the findings can be generalizable, to some extent, to European, Middle Eastern, and European American populations. This access to potentially invaluable, generalizable data has significant global health implications and opens possibilities for broader collaboration. The model outlined in this descriptive paper can serve as a blueprint for other health care organizations looking to develop similar collaborations for research and knowledge sharing. ",
doi="10.2196/53370",
url="https://ojphi.jmir.org/2024/1/e53370",
url="http://www.ncbi.nlm.nih.gov/pubmed/39348171"
}


@Article{info:doi/10.2196/59914,
author="Arunga, Simon
and Morley, Elise Katharine
and Kwaga, Teddy
and Morley, Gerard Michael
and Nakayama, Filipe Luis
and Mwavu, Rogers
and Kaggwa, Fred
and Ssempiira, Julius
and Celi, Anthony Leo
and Haberer, E. Jessica
and Obua, Celestino",
title="Assessment of Clinical Metadata on the Accuracy of Retinal Fundus Image Labels in Diabetic Retinopathy in Uganda: Case-Crossover Study Using the Multimodal Database of Retinal Images in Africa",
journal="JMIR Form Res",
year="2024",
month="Sep",
day="18",
volume="8",
pages="e59914",
keywords="image labeling",
keywords="metadata",
keywords="diabetic retinopathy",
keywords="assessment",
keywords="bias",
keywords="multimodal database",
keywords="retinal images",
keywords="Africa",
keywords="African",
keywords="artificial intelligence",
keywords="AI",
keywords="screening algorithms",
keywords="screening",
keywords="algorithms",
keywords="diabetic",
keywords="diabetes",
keywords="treatment",
keywords="sensitivity",
keywords="clinical images",
abstract="Background: Labeling color fundus photos (CFP) is an important step in the development of artificial intelligence screening algorithms for the detection of diabetic retinopathy (DR). Most studies use the International Classification of Diabetic Retinopathy (ICDR) to assign labels to CFP, plus the presence or absence of macular edema (ME). Images can be grouped as referrable or nonreferrable according to these classifications. There is little guidance in the literature about how to collect and use metadata as a part of the CFP labeling process. Objective: This study aimed to improve the quality of the Multimodal Database of Retinal Images in Africa (MoDRIA) by determining whether the availability of metadata during the image labeling process influences the accuracy, sensitivity, and specificity of image labels. MoDRIA was developed as one of the inaugural research projects of the Mbarara University Data Science Research Hub, part of the Data Science for Health Discovery and Innovation in Africa (DS-I Africa) initiative. Methods: This is a crossover assessment with 2 groups and 2 phases. Each group had 10 randomly assigned labelers who provided an ICDR score and the presence or absence of ME for each of the 50 CFP in a test image with and without metadata including blood pressure, visual acuity, glucose, and medical history. Specificity and sensitivity of referable retinopathy were based on ICDR scores, and ME was calculated using a 2-sided t test. Comparison of sensitivity and specificity for ICDR scores and ME with and without metadata for each participant was calculated using the Wilcoxon signed rank test. Statistical significance was set at P<.05. Results: The sensitivity for identifying referrable DR with metadata was 92.8\% (95\% CI 87.6-98.0) compared with 93.3\% (95\% CI 87.6-98.9) without metadata, and the specificity was 84.9\% (95\% CI 75.1-94.6) with metadata compared with 88.2\% (95\% CI 79.5-96.8) without metadata. The sensitivity for identifying the presence of ME was 64.3\% (95\% CI 57.6-71.0) with metadata, compared with 63.1\% (95\% CI 53.4-73.0) without metadata, and the specificity was 86.5\% (95\% CI 81.4-91.5) with metadata compared with 87.7\% (95\% CI 83.9-91.5) without metadata. The sensitivity and specificity of the ICDR score and the presence or absence of ME were calculated for each labeler with and without metadata. No findings were statistically significant. Conclusions: The sensitivity and specificity scores for the detection of referrable DR were slightly better without metadata, but the difference was not statistically significant. We cannot make definitive conclusions about the impact of metadata on the sensitivity and specificity of image labels in our study. Given the importance of metadata in clinical situations, we believe that metadata may benefit labeling quality. A more rigorous study to determine the sensitivity and specificity of CFP labels with and without metadata is recommended. ",
doi="10.2196/59914",
url="https://formative.jmir.org/2024/1/e59914"
}


@Article{info:doi/10.2196/58465,
author="Yang, Jingzhen
and Alshaikh, Enas
and Yu, Deyue
and Kerwin, Thomas
and Rundus, Christopher
and Zhang, Fangda
and Wrabel, G. Cameron
and Perry, Landon
and Lu, Zhong-Lin",
title="Visual Function and Driving Performance Under Different Lighting Conditions in Older Drivers: Preliminary Results From an Observational Study",
journal="JMIR Form Res",
year="2024",
month="Jun",
day="26",
volume="8",
pages="e58465",
keywords="nighttime driving",
keywords="functional vision",
keywords="driving simulation",
keywords="older drivers",
keywords="visual functions",
keywords="photopic",
keywords="mesopic",
keywords="glare",
keywords="driving simulator",
abstract="Background: Age-related vision changes significantly contribute to fatal crashes at night among older drivers. However, the effects of lighting conditions on age-related vision changes and associated driving performance remain unclear. Objective: This pilot study examined the associations between visual function and driving performance assessed by a high-fidelity driving simulator among drivers 60 and older across 3 lighting conditions: daytime (photopic), nighttime (mesopic), and nighttime with glare. Methods: Active drivers aged 60 years or older participated in visual function assessments and simulated driving on a high-fidelity driving simulator. Visual acuity (VA), contrast sensitivity function (CSF), and visual field map (VFM) were measured using quantitative VA, quantitative CSF, and quantitative VFM procedures under photopic and mesopic conditions. VA and CSF were also obtained in the presence of glare in the mesopic condition. Two summary metrics, the area under the log CSF (AULCSF) and volume under the surface of VFM (VUSVFM), quantified CSF and VFM. Driving performance measures (average speed, SD of speed [SDspeed], SD of lane position (SDLP), and reaction time) were assessed under daytime, nighttime, and nighttime with glare conditions. Pearson correlations determined the associations between visual function and driving performance across the 3 lighting conditions. Results: Of the 20 drivers included, the average age was 70.3 years; 55\% were male. Poor photopic VA was significantly correlated with greater SDspeed (r=0.26; P<.001) and greater SDLP (r=0.31; P<.001). Poor photopic AULCSF was correlated with greater SDLP (r=--0.22; P=.01). Poor mesopic VUSFVM was significantly correlated with slower average speed (r=--0.24; P=.007), larger SDspeed (r=--0.19; P=.04), greater SDLP (r=--0.22; P=.007), and longer reaction times (r=--0.22; P=.04) while driving at night. For functional vision in the mesopic condition with glare, poor VA was significantly correlated with longer reaction times (r=0.21; P=.046) while driving at night with glare; poor AULCSF was significantly correlated with slower speed (r=--0.32; P<.001), greater SDLP (r=--0.26; P=.001) and longer reaction times (r=--0.2; P=.04) while driving at night with glare. No other significant correlations were observed between visual function and driving performance under the same lighting conditions. Conclusions: Visual functions differentially affect driving performance in different lighting conditions among older drivers, with more substantial impacts on driving during nighttime, especially in glare. Additional research with larger sample sizes is needed to confirm these results. ",
doi="10.2196/58465",
url="https://formative.jmir.org/2024/1/e58465",
url="http://www.ncbi.nlm.nih.gov/pubmed/38922681"
}


@Article{info:doi/10.2196/49852,
author="Choi, Kyungseon
and Park, Jun Sang
and Han, Sola
and Mun, Yongseok
and Lee, Yun Da
and Chang, Dong-Jin
and Kim, Seok
and Yoo, Sooyoung
and Woo, Joon Se
and Park, Hyung Kyu
and Suh, Sun Hae",
title="Patient-Centered Economic Burden of Exudative Age-Related Macular Degeneration: Retrospective Cohort Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Dec",
day="8",
volume="9",
pages="e49852",
keywords="blindness",
keywords="age-related macular degeneration",
keywords="economic burden",
keywords="cost of illness",
keywords="retrospective cohort study",
keywords="common data model",
abstract="Background: Exudative age-related macular degeneration (AMD), one of the leading causes of blindness, requires expensive drugs such as anti--vascular endothelial growth factor (VEGF) agents. The long-term regular use of effective but expensive drugs causes an economic burden for patients with exudative AMD. However, there are no studies on the long-term patient-centered economic burden of exudative AMD after reimbursement of anti-VEGFs. Objective: This study aimed to evaluate the patient-centered economic burden of exudative AMD for 2 years, including nonreimbursement and out-of-pocket costs, compared with nonexudative AMD using the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). Methods: This retrospective cohort study was conducted using the OMOP CDM, which included 2,006,478 patients who visited Seoul National University Bundang Hospital from June 2003 to July 2019. We defined the exudative AMD group as patients aged >50 years with a diagnosis of exudative AMD and a prescription for anti-VEGFs or verteporfin. The control group was defined as patients aged >50 years without a diagnosis of exudative AMD or a prescription for anti-VEGFs or verteporfin. To adjust for selection bias, controls were matched by propensity scores using regularized logistic regression with a Laplace prior. We measured any medical cost occurring in the hospital as the economic burden of exudative AMD during a 2-year follow-up period using 4 categories: total medical cost, reimbursement cost, nonreimbursement cost, and out-of-pocket cost. To estimate the average cost by adjusting the confounding variable and overcoming the positive skewness of costs, we used an exponential conditional model with a generalized linear model. Results: We identified 931 patients with exudative AMD and matched 783 (84.1\%) with 2918 patients with nonexudative AMD. In the exponential conditional model, the total medical, reimbursement, nonreimbursement, and out-of-pocket incremental costs were estimated at US \$3426, US \$3130, US \$366, and US \$561, respectively, in the first year and US \$1829, US \$1461, US \$373, and US \$507, respectively, in the second year. All incremental costs in the exudative AMD group were 1.89 to 4.25 and 3.50 to 5.09 times higher in the first and second year, respectively, than those in the control group (P<.001 in all cases). Conclusions: Exudative AMD had a significantly greater economic impact (P<.001) for 2 years on reimbursement, nonreimbursement, and out-of-pocket costs than nonexudative AMD after adjusting for baseline demographic and clinical characteristics using the OMOP CDM. Although economic policies could relieve the economic burden of patients with exudative AMD over time, the out-of-pocket cost of exudative AMD was still higher than that of nonexudative AMD for 2 years. Our findings support the need for expanding reimbursement strategies for patients with exudative AMD given the significant economic burden faced by patients with incurable and fatal diseases both in South Korea and worldwide. ",
doi="10.2196/49852",
url="https://publichealth.jmir.org/2023/1/e49852",
url="http://www.ncbi.nlm.nih.gov/pubmed/38064251"
}


@Article{info:doi/10.2196/47349,
author="Jiang, Bo
and Wu, Tianhong
and Liu, Weiming
and Liu, Gaoqin
and Lu, Peirong",
title="Changing Trends in the Global Burden of Cataract Over the Past 30 Years: Retrospective Data Analysis of the Global Burden of Disease Study 2019",
journal="JMIR Public Health Surveill",
year="2023",
month="Dec",
day="5",
volume="9",
pages="e47349",
keywords="burden",
keywords="cataract",
keywords="disability-adjusted life-years",
keywords="human development index",
keywords="prediction",
keywords="risk factor",
abstract="Background: Cataracts now account for the largest proportion of the global burden of blindness and vision loss. Understanding the changing trends in the global burden of cataracts over the past 30 years and the next 15 years is of clear significance for the prevention and control of cataracts in key populations. As far as we know, research on the future burden of cataracts is lacking. Objective: This study aims to assess the global burden of cataracts over the past 30 years by using age-period-cohort modeling and to estimate trends in the next 15 years. Methods: Data were obtained from the Global Burden of Disease Study 2019, the United Nations Development Programme, and the WHO (World Health Organization) Global Health Observatory data repository. The assessment of trends and disparities in the number and rate of disability-adjusted life years (DALYs) for cataracts from 1990 to 2019 was conducted. The association between the age-standardized DALY rate (ASDR) and the socio-demographic index (SDI), human development index (HDI), national levels of particulate matter <2.5 $\mu$m in diameter (PM2.5), and ambient ultraviolet radiation (UVR) was determined using linear regression analysis. Additionally, we used the Nordpred (Harald Fekj{\ae}r and Bj{\o}rn M{\o}ller) age-period-cohort model to predict the cataract burden from 2020 to 2034. Results: Globally, the number of DALYs due to cataract increased from 3,492,604 (95\% uncertainty interval [UI] 2,481,846-4,719,629) in 1990 to 6,676,281 (95\% UI 4,761,210-9,006,193) in 2019. The ASDRs due to cataract decreased from 93.17 (95\% UI 66.14-125.32) in 1990 to 82.94 (95\% UI 59.06-111.75) in 2019, with an average annual percentage change of --0.37 (95\% CI --0.44 to --0.3; P<.001). Age, female sex, air pollution, smoking, high fasting plasma glucose levels, and a high body mass index were risk factors for the burden of cataracts. SDI and HDI were negatively correlated with ASDRs of cataracts, while PM2.5 and UVR were positively associated with them. Higher DALY rates were also associated with lower SDI (R2=0.1939; P<.001), lower HDI (R2=0.2828; P<.001), national PM2.5 concentration (R2=0.1874; P<.001), and ambient UVR levels (R2=0.2354; P<.001). The prediction model suggested that the number of DALYs due to cataract will continue to rise globally, while the cataract DALY rate will continue to decrease. Conclusions: While the ASDR of cataracts has decreased, there has been a notable increase in the number of DALYs over the past 30 years. Projections suggest that the global burden of cataracts will continue to rise over the next 15 years. To address this challenge, appropriate prevention and treatment policies must be implemented. ",
doi="10.2196/47349",
url="https://publichealth.jmir.org/2023/1/e47349",
url="http://www.ncbi.nlm.nih.gov/pubmed/38051579"
}


@Article{info:doi/10.2196/39314,
author="Wang, Qiong
and Zhang, Shimin
and Wang, Yi
and Zhao, Dan
and Zhou, Chengchao",
title="Dual Sensory Impairment as a Predictor of Loneliness and Isolation in Older Adults: National Cohort Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Nov",
day="14",
volume="8",
number="11",
pages="e39314",
keywords="loneliness",
keywords="social isolation",
keywords="dual sensory impairment",
keywords="vision impairment",
keywords="hearing impairment",
keywords="mental health",
abstract="Background: Loneliness and social isolation are global public health challenges. Sensory impairments (SIs) are highly prevalent among older adults but are often ignored as a part of normal aging. Identifying the role of SIs in loneliness and social isolation could provide insight into strategies for improving public health among older adults. Objective: This study aims to analyze the effects of SIs on loneliness and social isolation among older adults in rural and urban China. Methods: This cohort study of 3069 older adults (aged 60+) used data from 4 waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey of adults aged 45 years or older. SIs include hearing impairment (HI), vision impairment (VI), and dual sensory impairment (DSI). DSI is defined as the co-occurrence of VI and HI. Participants with complete data on hearing, vision, social isolation, and loneliness were included in the analysis. Generalized estimating equation models adjusted for covariates were used to examine the relationships of DSI with loneliness and social isolation among older adults. Results: Older adults in rural areas have higher prevalence of DSI, loneliness, and social isolation than their urban counterparts. In rural areas, participants with VI only (odds ratio [OR] 1.34, 95\% CI 1.12-1.62; P=.002), HI only (OR 1.32, 95\% CI 1.02-1.71; P=.03), and DSI (OR 1.84, 95\% CI 1.56-2.18; P<.001) were more likely to experience loneliness compared with participants without SIs. DSI showed a statistically significant association with loneliness compared with VI only (OR 1.37, 95\% CI 1.22-1.54; P<.001) and HI only (OR 1.39, 95\% CI 1.13-1.72; P=.002). In urban areas, participants with VI only (OR 2.44, 95\% CI 1.57-3.80; P<.001), HI only (OR 2.47, 95\% CI 1.41-4.32; P=.002), and DSI (OR 1.88, 95\% CI 1.24-2.85; P=.003) were more likely to experience loneliness compared with participants without SIs. DSI was not associated with the increased likelihood of loneliness compared with HI only or VI only. SIs were not associated with social isolation among older adults in urban and rural areas. Until 2018, 86.97\% (2669/3069) reported VI, but only 27.11\% (832/3069) and 9.45\% (290/3069) were treated with glasses and cataract surgery, respectively; besides, 75 individuals received both glasses and cataract surgery treatment. The prevalence of HI was 74.39\% (2283/3069) in 2018, but only 0.72\% (22/3069) were treated with a hearing aid. Conclusions: SIs are associated with an increased risk of loneliness rather than social isolation. A compounded risk of DSI on loneliness exists in rural areas rather than in urban areas. These findings expand our knowledge about the effects of SIs on loneliness and social isolation in non-Western populations. Interventions targeting HI only and DSI might be particularly effective for mitigating loneliness of older adults in urban and rural areas, respectively. Considering the high prevalence and low treatment rate of SIs, measures should be taken to make treatment more accessible. ",
doi="10.2196/39314",
url="https://publichealth.jmir.org/2022/11/e39314",
url="http://www.ncbi.nlm.nih.gov/pubmed/36374533"
}


@Article{info:doi/10.2196/19931,
author="Wittich, Walter
and Pichora-Fuller, Kathleen M.
and Johnson, Aaron
and Joubert, Sven
and Kehayia, Eva
and Bachir, Vanessa
and Aubin, Gabrielle
and Jaiswal, Atul
and Phillips, Natalie",
title="Effect of Reading Rehabilitation for Age-Related Macular Degeneration on Cognitive Functioning: Protocol for a Nonrandomized Pre-Post Intervention Study",
journal="JMIR Res Protoc",
year="2021",
month="Mar",
day="11",
volume="10",
number="3",
pages="e19931",
keywords="low vision",
keywords="rehabilitation",
keywords="cognition",
keywords="aging",
keywords="dementia",
keywords="reading",
abstract="Background: Age-related vision impairments and dementia both become more prevalent with increasing age. Research into the mechanisms of these conditions has proposed that some of their causes (eg, macular degeneration/glaucoma and Alzheimer's disease) could be symptoms of an underlying common cause. Research into sensory-cognitive aging has provided data that sensory decline may be linked to the progression of dementia through reduced sensory stimulation. While hearing loss rehabilitation may have a beneficial effect on cognitive functioning, there are no data available on whether low vision rehabilitation, specifically for reading, could have a beneficial effect on cognitive health. Objective: The research questions are: (1) Does low vision rehabilitation reduce reading effort? (2) If so, does reduced reading effort increase reading activity, and (3) If so, does increased reading activity improve cognitive functioning? The primary objective is to evaluate cognition before, as well as at 6 months and 12 months after, 3 weeks of low vision reading rehabilitation using magnification in individuals with age-related macular degeneration, with or without coexisting hearing impairments. We hypothesize that improvements postrehab will be observed at 6 months and maintained at 12 months for participants with vision loss and less so for those with dual sensory loss. The secondary objective is to correlate participant characteristics with all cognitive outcomes to identify which may play an important role in reading rehabilitation. Methods: We employ a quasiexperimental approach (nonrandomized, pre-post intervention study). A 3x3 design (3 groups x 3 time points) allows us to examine whether cognitive performance will change before and after 6 months and 12 months of a low vision reading intervention, when comparing 75 low vision and 75 dual sensory impaired (vision \& hearing) participants to 75 age-matched healthy controls. The study includes outcome measures of vision (eg, reading acuity and speed), cognition (eg, short-term and long-term memory, processing speed), participant descriptors, demographics, and clinical data (eg, speech perception in noise, mental health). Results: The study has received approval, and recruitment began on April 24, 2019. As of March 4, 2021, 38 low vision and 7 control participants have been enrolled. Lockdown forced a pause in recruitment, which will recommence once the COVID-19 crisis has reached a point where face-to-face data collection with older adults becomes feasible again. Conclusions: Evidence of protective effects caused by reading rehabilitation will have a considerable impact on the vision rehabilitation community and their clients as well as all professionals involved in the care of older adults with or without dementia. If we demonstrate that reading rehabilitation has a beneficial effect on cognition, the demand for rehabilitation services will increase, potentially preventing cognitive decline across groups of older adults at risk of developing macular degeneration. Trial Registration: ClinicalTrials.gov NCT04276610; Unique Protocol ID: CRIR-1284-1217; https://clinicaltrials.gov/ct2/show/NCT04276610 International Registered Report Identifier (IRRID): DERR1-10.2196/19931 ",
doi="10.2196/19931",
url="https://www.researchprotocols.org/2021/3/e19931",
url="http://www.ncbi.nlm.nih.gov/pubmed/33704074"
}


@Article{info:doi/10.2196/18306,
author="Wolffsohn, S. James
and Leteneux-Pantais, Claudia
and Chiva-Razavi, Sima
and Bentley, Sarah
and Johnson, Chloe
and Findley, Amy
and Tolley, Chloe
and Arbuckle, Rob
and Kommineni, Jyothi
and Tyagi, Nishith",
title="Social Media Listening to Understand the Lived Experience of Presbyopia: Systematic Search and Content Analysis Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="21",
volume="22",
number="9",
pages="e18306",
keywords="presbyopia",
keywords="near vision",
keywords="social media",
keywords="social media listening",
keywords="infodemiology",
abstract="Background: Presbyopia is defined as the age-related deterioration of near vision over time which is experienced in over 80\% of people aged 40 years or older. Individuals with presbyopia have difficulty with tasks that rely on near vision. It is not currently possible to stop or reverse the aging process that causes presbyopia; generally, it is corrected with glasses, contact lenses, surgery, or the use of a magnifying glass. Objective: This study aimed to explore how individuals used social media to describe their experience of presbyopia with regard to the symptoms experienced and the impacts of presbyopia on their quality of life. Methods: Social media sources including Twitter, forums, blogs, and news outlets were searched using a predefined search string relating to symptoms and impacts of presbyopia. The data that were downloaded, based on the keywords, underwent manual review to identify relevant data points. Relevant posts were further manually analyzed through a process of data tagging, categorization, and clustering. Key themes relating to symptoms, impacts, treatment, and lived experiences were identified. Results: A total of 4456 social media posts related to presbyopia were identified between May 2017 and August 2017. Using a random sampling methodology, we selected 2229 (50.0\%) posts for manual review, with 1470 (65.9\%) of these 2229 posts identified as relevant to the study objectives. Twitter was the most commonly used channel for discussions on presbyopia compared to forums and blogs. The majority of relevant posts originated in Spain (559/1470, 38.0\%) and the United States (426/1470, 29.0\%). Of the relevant posts, 270/1470 (18.4\%) were categorized as posts written by individuals who have presbyopia, of which 37 of the 270 posts (13.7\%) discussed symptoms. On social media, individuals with presbyopia most frequently reported experiencing difficulty reading small print (24/37, 64.9\%), difficulty focusing on near objects (15/37, 40.5\%), eye strain (12/37, 32.4\%), headaches (9/37, 24.3\%), and blurred vision (8/37, 21.6\%). 81 of the 270 posts (30.0\%) discussed impacts of presbyopia---emotional burden (57/81, 70.4\%), functional or daily living impacts (46/81, 56.8\%), such as difficulty reading (46/81, 56.8\%) and using electronic devices (21/81, 25.9\%), and impacts on work (3/81, 3.7\%). Conclusions: Findings from this social media listening study provided insight into how people with presbyopia discuss their condition online and highlight the impact of presbyopia on individuals' quality of life. The social media listening methodology can be used to generate insights into the lived experience of a condition, but it is recommended that this research be combined with prospective qualitative research for added rigor and for confirmation of the relevance of the findings. ",
doi="10.2196/18306",
url="http://www.jmir.org/2020/9/e18306/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32955443"
}


@Article{info:doi/10.5210/ojphi.v5i1.4503,
title="Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review",
journal="Online J Public Health Inform",
year="2013",
volume="5",
number="1",
pages="e4503",
doi="10.5210/ojphi.v5i1.4503",
url=""
}