Visual Difficulty, Race and Ethnicity, and Activity Limitation Trajectories Among Older Adults in the United States: Findings from the National Health and Aging Trends Study

Abstract

Abstract Objectives To characterize the influence of visual difficulty on activity limitation trajectories in older U.S. adults and investigate whether this varied across racial/ethnic groups. Methods We used data from 8,077 participants in the nationally representative National Health and Aging Trends Study from 2011-2019. Using mixed effects regression models, we investigated the association of self-reported visual difficulty and race/ethnicity with activity limitation trajectories. Results Higher levels of visual difficulty and belonging to a minority racial/ethnic group were associated with greater mobility, self-care, and household activity limitations. Visual difficulty was associated with mobility and self-care activity limitation trajectories and race/ethnicity was significantly associated with mobility and household activity limitation trajectories. Among those with the highest levels of visual difficulty, non-Hispanic Black participants experienced a faster rate of decline in self-care activities compared to non-Hispanic White participants. Discussion Promoting optimal aging for all requires an understanding of the factors that influence disparities in key outcomes. Our study provides evidence from a diverse national sample that visual difficulty appears to disproportionately impact activity limitation trajectories among older adults from minority racial/ethnic groups, and particularly among non-Hispanic Blacks. Further research is needed to determine whether interventions to promote healthy vision may positively impact overall activity and independence and ameliorate disparities in late-life activity limitation trajectories.