Validation of the International Reading Speed Texts in a Sample of Older (60+) Canadian Adults

Comparison of binocular reading speed in patients with strabismus without amblyopia versus controls

OBJECTIVE

Amblyopia has been shown to slow reading speed. Limited literature exists on reading speed in strabismus without amblyopia. Our study compares binocular reading speed in patients with strabismus without amblyopia versus normal controls.

METHODS

We conducted a prospective study with 48 participants: 12 childhood-onset (onset <8 years of age) strabismus without amblyopia and 36 age- and education level-matched controls. Inclusion criteria were age 14-50 years, education >9 years, primary language English, best-corrected visual acuity >20/30 distance, and >N8 near either eye. Exclusion criteria were presence of other eye pathology or neurologic/cognitive conditions that may affect reading and previous treatment for strabismus/amblyopia. International Reading Speed Texts were used for binocular reading speed assessment. Each participant read 2 passages (passage 1 and 8), following all International Reading Speed Texts instructions. Reading time was measured using a stopwatch. Reading speed was calculated in words per minute (WPM).

RESULTS

Mean age for the strabismus group was 28.3 ± 11.1 and for the control group was 28.2 ± 11.0 years (P = 0.96). Mean education level for strabismus group was 14.2 ± 2.4 and control group was 13.8 ± 2.5 years (P = 0.62). Mean binocular reading speed for passage 1 for strabismus group was 192.0 and for control group was 220.0 WPM (P = 0.01). Mean binocular reading speed for passage 8 for strabismus group was 201.3 and for control group was 226.2 WPM (P = 0.04).

CONCLUSIONS

Patients with strabismus (without amblyopia) had slower binocular reading speed compared with controls. Further studies with eye tracking may provide more information. Strabismus, even without amblyopia, may affect reading performance and consequently vision-related quality of life.

Reading Speed Using the International Reading Speed Texts in a Normal Canadian Cohort

Background The International Reading Speed Texts (IReST) are commonly used to measure reading speed, which may be affected in many eye conditions. They were originally tested in a younger British population. Our study evaluates IReST in a normal Canadian population. Methodology A normal Canadian cohort in Ontario was prospectively recruited with age >14 years, education >9 years, English as the primary language, and best-corrected visual acuity >20/25 distance and >N8 near in each eye. Participants with eye conditions and neurological/cognitive problems were excluded. Each participant consecutively read two IReST passages (passages 1 and 8). Reading speed in words per minute (WPM) was calculated. One-sample t-test was used to compare our cohort to published IReST standards. Results A total of 112 participants were included (35 male, 77 female). The mean age was 40 ± 17 years (14-18 years: 12; 18-35 years: 34; 35-60 years: 53; 60-75 years: 13). The mean reading speed for passage 1 was 211 ± 33 WPM compared to the published IReST standard of 236 ± 29 WPM (p < 0.0001). The mean reading speed for passage 8 was 218 ± 34 WPM compared to the IReST standard of 237 ± 24 WPM (p < 0.0001). Thus, our cohort read slower for both passages compared to IReST standards. The mean reading speed for passages 1 and 8 was the highest for the 14-18-year (231 and 239, respectively) and the lowest for the 60-75-year group (195 and 192, respectively). Conclusions Normal older populations have slower reading compared to younger populations. The slower reading in our cohort may also be because the passages were in British rather than in Canadian English. It is important that the IReST is evaluated in different populations to ensure reliable comparison standards for future research.

Visual and cognitive functioning among older adults with low vision before vision rehabilitation: A pilot study

Introduction

The occurrence of age-related vision changes is inevitable. However, some of these changes can become pathological. Research indicates that vision and hearing loss is correlated with age-related cognitive decline, and with a higher risk of developing dementia due to Alzheimer's disease. Low vision rehabilitation could possibly be a protective factor against cognitive decline, as it provides the clients with compensatory strategies to overcome their visual deficits.

Objectives and hypothesis

The aim of this pilot study was to assess correlations between visual and cognitive functions in older adults referred for low vision rehabilitation. We hypothesized that more severe impairment of visual acuity and contrast sensitivity would be correlated with more advanced levels of cognitive impairment. The second objective was to examine which of these correlations would remain significant once established variables that influence cognition are statistically removed (e.g., age, education).

Methods

Thirty-eight older adults (age range: 66-97 years old) with a visual impairment (acuity <20/70) were recruited before the onset of their low vision rehabilitation. They underwent vision (reading acuity, reading speed, contrast sensitivity), hearing (audiogram, speech-in-noise perception) and cognitive (global cognition, memory, executive functions) testing, and demographic information was obtained.

Results and discussion

Correlations among global cognition and visual aid use, memory and reading speed, memory and contrast sensitivity, memory, and visual aid use, and between executive functions and contrast sensitivity were significant. Correlations between contrast sensitivity and memory, as well as between global cognition and visual aid use remained significant after controlling for age and education. The present study is relevant to clinicians who are assessing the cognitive status of older adults, such as neuropsychologists, because it highlights the importance of considering low vision when administering neuropsychological tests, especially to persons who have not yet received rehabilitation for their visual impairment.

Assessing optimal colour and illumination to facilitate reading: an analysis of print size

PURPOSE

This study examined how optimal colour/illumination conditions and the efficacy of the iPad, LuxIQ and Smart Bulb varied as a function of print size in younger, older and visually impaired adults.

METHODS

Participants with visual impairments and simulated low vision (SLV) read the MNRead using the iPad, LuxIQ and Smart Bulb.

RESULTS

In the impairment condition at 1.20 logMAR, the iPad (M = 9.49, 95% CI [3.18, 19.42]) and LuxIQ (M = 15.95, 95% CI [9.54, 24.86]) improved the reading speeds. At 0.80 logMAR (SLV), all devices improved reading speeds of older adults (iPad (M = 28.70, 95% CI [14.65, 42.51]); LuxIQ (M = 49.63, 95% CI [30.04, 69.68]); Smart Bulb (M = 23.11, 95% CI [3.33, 42.11])), but in younger adults only the LuxIQ (M = 13.04, 95% CI [3.21, 21.27]) did so. In the impairment condition, the iPad (M = 5.54, 95% CI [0.31, 12.13]) and LuxIQ (M = 13.90, 95% CI [7.88, 23.49]) improved reading speeds. In the SLV condition, age was a significant predictor of reading speed at 1.20 logMAR (F_3,164  = 10.74, p < 0.001, Adj. R²  = 0.16). At 0.80 logMAR, age and luminance, but not colour, were significant predictors (F_3,164  = 52.52, p < 0.001, Adj. R²  = 0.49). In the impairment condition, both age and lux were significant predictors of reading speed at 1.20 (F_3,85  = 7.14, p < 0.001, Adj. R²  = 0.20) and 0.80 logMAR (F_3,85  = 7.97, p < 0.001, Adj. R²  = 0.22), but colour was not.

CONCLUSIONS

Light source effectiveness and optimal colour/illumination vary as a function of print size. It appears that print size is the most important factor for improving reading speed. As print size decreases, luminance becomes crucial, and only at the smallest print sizes does the effect of colour become useful.