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University of Iowa News Release

Release: April 11, 2002

UI Study Looks At Screening Elderly In Eye Clinics

The results of a pilot study, appearing in the April issue of Ophthalmology, show screening elderly patients in an outpatient ophthalmic clinic may be an effective way to screen for dementia, depression and functional impairment. Ophthalmology is the clinical journal of the American Academy of Ophthalmology.

Some 50 ophthalmology clinic outpatients (age 65 and older) seen in the comprehensive eye and neuro-ophthalmology clinics at University of Iowa Hospitals and Clinics were asked to complete a short questionnaire to determine if the patients functioned well and independently in their activities of daily living; answer a single question on depression; and complete a simple clock-drawing task to screen for dementia.

Some 12 percent of the study participants were identified with functional impairment, 20 percent showed signs of depression and 20 percent showed signs of dementia.

Study author Andrew Lee, M.D., said, "Early detection can help patients obtain early treatment and might improve the quality of life for both patients and their caretakers." Lee, an associate professor in the UI department of ophthalmology and visual sciences, added, "Unfortunately, very little screening is done now."

The study is important because of the impending dramatic demographic shift toward an older population that is taking place in the United States.

"With increasing numbers of geriatric patients entering eye clinics, it might be important to recognize and possibly screen elderly patents for treatable geriatric conditions," Lee said.

The study showed there are several reasons why screening at eye clinics may be valuable. Among them are:
-- Ophthalmology clinics and practices tend to have a high number of elderly patients compared to other medical and surgical clinics.
-- Screening for depression, dementia and functional impairment has proven useful in other clinical settings. Easy-to-use screening tests have been used for years by geriatricians.
-- Patients with these conditions may not be able to cognitively process or interpret what they are looking at. The patient then misinterprets an inability to comprehend text or sort out complex visual information as a visual problem.

Hilary Beaver, M.D., assistant professor (clinical) of ophthalmology and visual sciences, Gerald Jogerst, M.D., associate professor (clinical) of family medicine, and Jeanette Daly, Ph.D, a registered nurse and geriatric care specialist, also contributed to the research effort. The study authors said the goal of their work was not to make ophthalmologists into geriatricians, but to increase geriatrics expertise and awareness by ophthalmologists. This would allow them to make appropriate referrals for more comprehensive geriatrics assessment.

"In a way, ophthalmologists may improve the overall health care as well as ocular health care in older adults," the research team stated.

The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons with more than 27,000 members worldwide. For more information about eye health care, visit the Academy's partner Web site, the Medem Network, at www.medem.com/eyemd. To find a vision specialist in your area, visit the Academy's Web site at www.aao.org.

University of Iowa Health Care describes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at www.uihealthcare.com.

STORY SOURCE: Joint Office for Planning, Marketing and Communications, University of Iowa Health Care, 200 Hawkins Drive, Room 8798 JPP, Iowa City, Iowa 52242-1009.

CONTACT: Tom Moore, 319-356-3945, thomas-moore@uiowa.edu.