Occupational therapy interventions to improve reading performance of older adults with low vision: A systematic review

Importance: Low vision affects many older adults and is expected to significantly increase over the next several decades. It has a significant impact on all aspects of daily life, including the reading required for participation in occupations. Objective: To determine the effectiveness of interventions within the scope of occupational therapy to improve reading required for the performance of occupations by older adults with low vision. Data Sources: We conducted a systematic review of literature published in the Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, and OTseeker databases from 2010 through 2016. The references of retrieved articles were also hand searched. Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to abstract and assess data quality and validity. This review followed the established methodology of the American Occupational Therapy Association Evidence-Based Practice Project. Findings: Sixteen articles met the inclusion criteria and were categorized into three themes: (1) technology, (2) visual skills training, and (3) multicomponent interventions. Moderate evidence supports stand-based electronic magnification and eccentric viewing training to improve reading outcomes. Strong evidence supports multicomponent interventions. Conclusions and Relevance: Occupational therapy practitioners working with older adults with low vision are strongly encouraged to integrate stand-based electronic magnification, eccentric viewing training, and comprehensive low vision services into routine care. Further research with larger sample sizes and functional reading outcome measures is needed.