Psychosocial adaptation to visual impairment and its relationship to depressive affect in older adults with age-related macular degeneration.

PURPOSE In this study we examined psychosocial adaptation to vision loss and its relationship to depressive symptomatology in legally blind older adults with age-related macular degeneration (ARMD). DESIGN AND METHODS The 144 study participants were outpatients of a large regional vision clinic that specializes in the diagnosis and treatment of ARMD in older adults. They were administered a battery of cognitive and psychological screening instruments including the Adaptation to Vision Loss Scale, the Short Portable Mental Status Questionnaire, and the short form of the Geriatric Depression Scale. RESULTS A principal components analysis of the Adaptation to Vision Loss Scale identified three distinct adaptation factors, namely, acceptance of vision loss, negative impact on relationships, and attitudes toward compensation. Of these, acceptance of vision loss and attitudes toward compensation were positively associated with depressive affect. In addition, self-reported use of outpatient rehabilitative services was less frequent in those reporting greater depressive symptomatology. IMPLICATIONS These findings support the contention that depressive symptomatology as measured by self-report in older adults with ARMD is mediated by one's perceived sense of individual control as it relates to intrapersonal factors underlying adaptation to profound vision loss in old age caused by ARMD.