Reading performance in older adults: The SKI study. The Fall Vision Meeting, Oct 24-27, 2002, San Francisco

Purpose: To assess reading performance in older adults with high contrast visual acuities ranging from 0.22-0.78 logMAR (i.e. 20/32-20/120), to determine the factors that affect reading, and to compare these findings to our previously published results on older adults with good high contrast acuity (>= 0.20 logMAR). Method: Reading performance was assessed using the Pepper Test, an oral test of random letters and words. The test was scored for speed and accuracy (corrected reading rate [CRR]= total number items correct/time). Mean acuity reserve was 0.25 log units. Subjects also completed an extensive battery of vision tests. Results: Not surprisingly, significant differences were obtained between elders with reduced vs. good acuity. The reduced acuity group was older (mean age= 81.8 vs. 72.8 yrs) and slower on the Pepper Test (CRR= 57.6 vs. 91.0 words per minute). Multiple linear regression revealed that contrast sensitivity, as well as low contrast acuity in glare, and gross motor ability were significant independent predictors of reading performance in the reduced acuity group, accounting for 44% of the variability. Our prior findings in those with good acuity indicated that low contrast/low luminance acuity, high contrast acuity, gross motor ability, impact of lighting changes on walking, and impact of divided attention on visual field size were all significant independent predictors of reading ability. These factors accounted for 36% of the variability in Pepper reading task performance. Conclusions: For older individuals with good or reduced acuity, once other factors are taken into account, age is no longer a significant independent predictor of reading performance. However, for the reduced acuity group, fewer factors are required to account for variability in reading performance. In both groups, we find substantial variation in reading performance that isn't accounted for by standard high contrast acuity, emphasizing the importance of assessing reading ability in older adults.