Factors associated with eye examination within the past year among older home care clients: A cross-sectional
Tiina Pesonen1, Johanna Edgren, Satu Elo
1Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland Department of Healthcare and Social Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland Oulu University of Applied Sciences, Oulu, Finland Department of Ophthalmology, Medical Research Center, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland Oulu University Hospital, Oulu, Finland.
Significance:
International guidelines recommend that older adults undergo eye examinations every 1 to 2 years. Eye examinations can identify vision issues at an early stage, enabling timely intervention to prevent or manage impaired vision.
Purpose:
We explored the prevalence of older home care clients who had undergone an eye examination within the past year and the associated factors.
Methods:
We used a cross-sectional register study design. The data were derived from the National Resident Assessment Instrument database, authorized by the Finnish Institute of Health and Welfare. We utilized data from home care clients who were aged 65 or older and had an assessment with the Resident Assessment Instrument conducted between April 1, 2022, and September 30, 2022 (n = 19,150). We used multivariate binary logistic regression to analyze factors associated with having an eye examination within the past year among home care clients.
Results:
Twenty-six percent of Finnish home care clients had undergone an eye examination within the past year. Having an eye examination within the past year was significantly associated with female gender (odds ratio [OR] 1.12; 95% confidence interval [CI] 1.04-1.20), impaired vision, especially moderate or severe impairment (OR 3.01; 95% CI 2.70-3.36), and mild hearing impairment (OR 1.13; 95% CI 1.04-1.22). Limited physical function, both needing supervision or limited assistance in activities of daily living (OR 0.78; 95% CI 0.72-0.85) and needing extensive assistance (OR 0.60; 95% CI 0.53-0.67), and mild cognitive impairment (OR 0.86; 95% CI 0.80-0.92), as well as moderate or severe cognitive impairment (OR 0.66; 95% CI 0.59-0.74), were associated with lower odds of having an eye examination within the past year.
Conclusions:
A significant share of home care clients may not seek or may be unable to attend eye examinations at the recommended intervals due to various barriers, such as limited physical function and cognitive decline. The opportunity to participate in eye examinations may require targeted support services, such as assistance or transport services, or the development of innovative home-based vision care services. In addition, home care professionals' awareness and competence regarding eye examination recommendations, available eye care services, and overall vision health should be strengthened.
