The psychological impact of instrumental activities of daily living on people with simulated age-related macular degeneration

BACKGROUND: People with age-related macular degeneration (AMD) can report reduced mental health. There is also evidence that they struggle with daily tasks because of vision loss. AIMS: The purpose of this study was to assess the psychological impact of instrumental activities of daily living on people with simulated AMD. METHOD: Twenty-four normally sighted participants completed 12 household tasks, in a simulated home environment, under a moderate-to-severe AMD simulation. Participants’ psychological state was measured through self-report questionnaires and physiological measurements related to anxiety and stress. Tasks were completed twice, under counterbalanced vision conditions (normal and simulated AMD). RESULTS: Linear mixed models on vision condition (normal versus simulated AMD) and trial order (trial 1 versus trial 2) revealed a significant large negative effect of the AMD simulation on time to complete tasks, and the anxiety, task engagement and distress self-reports (all P < 0.024, all ω(2) > 0.177). There were also significant medium-large effects of trial order on time, task incompletion, task errors, and the anxiety and task engagement self-reports (all P < 0.047, all ω(2) > 0.130), whereby the results improved during the second attempt at the tasks. No physiological measures were significant (all P > 0.05). CONCLUSIONS: Completing instrumental activities of daily living under an AMD simulation had a negative impact on participants’ self-reported mental state. The observed trial order effects also illuminated how practice with tasks could ease anxiety and stress over time.