A randomized controlled trial of a health-promotion programme and its effect on ADL dependence and self-reported health problems for the elderly visually impaired

Background: Ageing with visual impairment is associated with a high degree of disability whereby age-related macular degeneration in particular causes dependence in activities of daily living (ADL) even at an early stage. Aims: To compare an activity-based, health-pro motion programme with an individual programme, targeting the elderly with age-related macular degeneration concerning the effect on the development of dependence in ADL, general health, and self-reported health problems. Methods: A randomized controlled study with a 28-month follow-up. A total of 229 persons were randomized to the study and 131 (57%) were followed up (individual intervention n =69, health-promotion programme n =62) at 28month. Results: The health-promotion group maintained their ADL level despite a significant decrease in visual acuity, while the individual intervention group increased its dependence in ADL. General health systematically dropped to a lower level in both groups, but participants from the health-promotion group reported fewer health problems. There were significantly fewer reports of tiredness and dizziness among the health-promotion participants. Conclusion: The health-promotion programme seems to have slowed down the disablement process among elderly with decreased vision by enabling them to maintain their ADL level and by reducing self-reported health problems for at least 28 months following intervention.