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Jennifer Fortuna, PhD, OTRL


Background: Age-related macular degeneration (AMD) is the leading cause of vision loss for Americans 65 years of age and older. Central vision loss makes reading challenging. Health literacy assessments that measure skills in basic literacy are often too demanding for people with AMD. The impact of central vision loss on functional health literacy has yet to be explored in the literature.

Methods: A between-subjects study design was employed to explore associations between functional health literacy and visual acuity in older adults with AMD. The Short Test of Functional Health Literacy in Adults (S-TOFHLA) was used to measure health literacy in participants across three severity categories (moderate, severe, profound) of visual impairment. Scores were recorded for timed (7 min) and untimed testing conditions for comparison.

Results: For the timed condition, 73% of the participants had inadequate health literacy and 27% had marginal health literacy. For the untimed condition, 100% of the participants had adequate health literacy. The severe category had the lowest mean S-TOFHLA score for both time conditions. This finding was unanticipated considering the strong correlation between visual acuity and reading performance.

Conclusion: All of the participants exhibited a drastic improvement in test scores when the time constraint was removed. Time may be an underrecognized factor of reading performance in older adults with AMD.