Institution: The Smith Kettlewell Eye Research Institute
Poster Title: Movement-related concerns and cognition in macular degeneration: clinical and laboratory insights
Abstract: Macular degeneration (MD) often leads to limitations in physical activities due to poor vision and fear of falling. Here, we present two complementary studies investigating mobility concerns in MD in the clinic and lab. Study 1 assessed self-reported balance and mobility concerns in 100 patients (?50 years) with binocular maculopathy during their low vision consultation. Patients were asked general balance and mobility questions and a questionnaire on mobility concerns. 53% of patients reported balance complaints, and 39% attributed mobility limitations to vision loss. Severity of vision deficit correlated with higher scores on the questionnaire, particularly in terms of contrast sensitivity (?=-0.58, p<0.001). This awareness of mobility issues led to 32% of patients being referred for mobility rehabilitation. Study 2 investigated mobility-related cognition and its relationship to movement patterns in 10 individuals with MD and 10 age-matched controls. Participants completed a gait-specific attentional questionnaire focusing on conscious movement processing (CMP) and ruminations. Head and trunk movements were recorded during the Timed Up and Go (TUG) functional mobility assessment. In the MD group, head acceleration and variability while walking increased with vision loss, suggesting poorer control (r=-0.73, p=0.026). Interestingly, higher rumination (?=-0.73, p=0.017) and CMP (?=-0.70, p=0.025) scores correlated with decreased head acceleration variability, suggesting improved control. Individuals with poorer vision also scored higher in CMP (?=0.73, p=0.027). These findings suggest that greater conscious movement processing and ruminations lead to more careful walking, though this process may be disrupted with greater vision loss. This complex relationship between physical and cognitive mobility changes, and vision loss severity highlights the need to assess and address these issues in the clinic. Though greater mobility concerns are linked to poorer vision, the associations found with cognitive processes while walking suggest protective mechanisms in MD that may be leveraged via training.