Psychosocial adaptation status and health-related quality of life among older Chinese adults with visual disorders Chong-Wen Wang Æ Cecilia L. W. Chan Accepted: 15 June 2009 / Published online: 28 June 2009 Ó Springer Science+Business Media B.V. 2009 Abstract Purpose To examine the association of psychosocial adaptation status with vision-specific health-related quality of life (HRQOL) and the role of psychosocial adaptation in the linkage between visual impairment and vision-specific HRQOL outcomes among older adults with visual disorders. Design and methods In this cross-sectional study, older urban adults with visual problems (N = 167) were inter- viewed using a structured questionnaire to assess their self- reported visual function, general health, psychosocial adaptation status, and vision-specific HRQOL. Perfor- mance-based measure of visual function marked by distance visual acuity was clinically conducted by ophthalmologists. Results It was found in the study that psychosocial adaptation status was significantly associated with vision- specific HRQOL, including the domains of mental health symptoms due to vision and dependency on others due to vision. The results also showed that psychosocial adapta- tion status could buffer the effect of visual impairment on vision-specific HRQOL, including the domains of social function, mental health, and dependency. Conclusion Psychosocial adaptation status is significantly associated with multiple domains of vision-specific HRQOL. The findings have significant implications for health education and psychosocial intervention for older adults with age-related vision loss. Keywords Quality of life Á Visual impairment Á Older adults Á Psychosocial adaptation Introduction Visual impairment is highly prevalent among older adults. A population-based study found that the prevalence of visual impairment in at least one eye was 41.3% among the elderly and that in those aged 80 years or older, 73.1% had visual impairment [1]. Previous studies have demonstrated that visual impairment may lead to physical disability, falls, and limitation in mobility, as well as difficulties with the basic activities of daily living [2–4]. Visual impairment is potentially distressing not only because of the disability, but also because of the fear of total vision loss, the possi- bility of future deterioration and interruptions to everyday life, as well as potential strains on relationships. Recent studies have suggested that not only is visual impairment a significant predictor of both onset and persistence of depression among older adults [5–7], but also an increase in depressive symptoms over time might predict a decline in self-reported vision function, independent of changes in visual acuity or medical status [8, 9]. Some studies have also suggested that psychological distress and depression were significantly associated with vision-related disability in older individuals with ocular conditions [10, 11]. However, few studies have examined the association between psychological status and health-related quality of life (HRQOL) among visually impaired older adults. In a situation of stressful life events, such as chronic illnesses and disabilities, e.g., vision loss, the individual may evaluate the significance of what is happening to his or her well-being and determine his or her adaptive responses to the threatening stressful event. In past years, a large number of studies focused on adaptation to chronic illnesses and disabilities. The term ‘‘adaptation’’ implies a balance between the demands and expectations of a given situation and the capacity of an individual to respond to those C.-W. Wang (&) Á C. L. W. Chan Centre on Behavioral Health, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China e-mail: chongwenn@hotmail.com 123 Qual Life Res (2009) 18:841–851 DOI 10.1007/s11136-009-9505-z