Cognitive Ability as a Resource for Everyday Functioning among Older Adults Who Are Visually Impaired
Heyl, Vera, Wahl, Hans-Werner, Journal of Visual Impairment & Blindness
Abstract: This article reports on a study that investigated the role of cognitive resources in the everyday functioning of 121 older adults who were visually impaired and 150 sighted older adults, with a mean age of 82 years. Cognitive performance and everyday functioning were most strongly related in the group who were visually impaired. The authors conclude that cognitive training enhances independent living skills.
There is robust evidence that higher cognitive functioning is substantially related to higher everyday functioning among older adults (see, for example, Diehl et al., 2005; Heyl, Wahl, & Mollenkopf, 2005). Most studies in this field of research have used behavior-oriented self-report measures, including activities of We thank the German Research Foundation for supporting this research with Grant WA 809/7-1 awarded to Hans-Werner Wahl. We extend our appreciation to Jost Jonas and Klaus Rohrschneider, who provided tremendous support in generating the sample of older adults with visual impairments. We also thank our project staff', particularly Nadine Langer and Christina Hunger, and the participants, who invested their time and energy to serve our research. daily living (ADLs), such as dressing; instrumental activities of daily living (IADLs) like preparing meals; and leisure activities (such as participating in sports) to assess everyday functioning. The relationship between cognitive functioning and the subjective evaluation of everyday functioning, that is, the individual's beliefs about being able to fulfill his or her day-to-day duties, has received less research attention. However, cognitive capacity may nurture such beliefs, since there is evidence that intellectual functioning is related to control beliefs regarding everyday cognitive tasks (such as remembering names) that are relevant to everyday functioning (Lachman & Left, 1989). Moreover, Seeman, McAvay, Merrill, Albert, and Rodin (1996) found that the cognitive ability of abstraction predicted higher instrumental efficacy beliefs (that is, beliefs about the ability to deal with instrumental aspects of one's life, such as arranging transportation) 2.5 years later.
Although it seems justified to consider cognitive functioning as a resource for everyday functioning among older individuals, it is not clear whether cognitive functioning is comparably important for the everyday functioning of older adults with and without major chronic conditions, such as vision loss. This question of cognitive functioning is crucial, however, since it has practical implications for tailoring interventions to the needs of older clients most efficiently and since visual impairment is common in old age. The prevalence of severe vision loss in older adults, which is prototypically due to age-related macular degeneration, is about 25% among those aged 75 and older (Eye Diseases Prevalence Research Group, 2004). Therefore, the aims of the study presented here were to determine the importance of cognitive resources for everyday functioning among older persons who are visually impaired and to extend knowledge on the subjective component of everyday functioning.
Studies that have addressed the role of visual impairment for the independent everyday functioning of older adults have consistently found a strong negative impact of vision loss, particularly on IADLs and out-of-home activities (for a review, see Burmedi, Becker, Heyl, Wahl, & Himmelsbach, 2002; Whitson et al., 2007). Since vision loss clearly threatens the functional autonomy of older adults, resources that are relevant to everyday functioning (such as cognitive functioning) may be of greater importance for those who are visually impaired than for those who are sighted. Because of reduced sensory input, older persons who are visually impaired may have to rely more on their cognitive resources when performing ADLs, IADLs, and leisure activities. As a consequence, their subjective evaluation of everyday functioning may also depend more strongly on cognitive functioning than may the subjective evaluation of sighted older adults. …