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Swenor Research Group

Dr. Bonnielin Swenor's research aims to improve the health of people with visual impairments and is fueled by her personal experience living with a visual disability. To achieve this, Dr. Swenor’s research has concentrated on three interrelated areas:

Vision and Aging: examining the impact of visual impairments on health and well-being across the lifespan, with a focus on older adults
Access to Care: documenting health care disparities and improving healthcare utilization, quality, and access in patients with vision loss
Disability Inclusion: enhancing the inclusion of persons with visual impairments and other disabilities in the biomedical workforce.

Dr. Swenor and her team are now expanding on this research framework to more broadly examine disability health. This area of research examines disability – including visual impairment - as a health disparity population, and uses an interdisciplinary, collaborative approach to establish the evidence needed to design effective policies and programs that will reduce disability health disparities. The overarching goals of this research are to maximize health, equity, and participation for persons with all types of disabilities.


Vision and Aging

The Swenor Research Group focuses on examining the interrelationship between vision loss and aging. This includes determining the effects of visual impairment and eye disease on physical and cognitive functioning in older adults, and identifying interventions that could enhance the health of older adults with visual impairment and eye disease.

swenor research framework chart
Figure: Swenor BK, et al. Aging With Vision Loss:A Framework for Assessing the Impact of Visual Impairment on Older Adults. Gerontologist. 2019 Aug 24. pii: gnz117.

This work is guided by an overarching research framework (Figure) that integrates concepts and terminology from both ophthalmology and geriatrics. Under this framework, visual impairment leads to downstream changes in functioning – physical, cognitive, and social/psychological functioning – that in turn lead to negative health outcomes associated with accelerated aging – including frailty, comorbidity, and increased risk of mortality. This framework also acknowledges the complexity of these relationships, as there are common causes or risk factors that may contribute to functioning decrements and negative health consequences among older adults with visual impairments. To achieve these goals, Dr. Swenor’s research team relies on a highly collaborative approach working with investigators across multiple departments, The Dana Center for Preventive Ophthalmology and the Johns Hopkins Center on Aging and Health.

Cognitive Impairment and Neuroimaging

Prior research has indicated that visually impaired older adults are more likely to have cognitive impairment than those with normal vision. However, the mechanisms underlying this relationship are not fully understood, limiting our ability to mitigate the cognitive consequences of vision loss. Dr. Swenor’s research is advancing understanding of the vision-cognitive relationship by leveraging longitudinal studies, as well as neuroimaging data to investigate how brain structure and function may change in older adults with age-related eye disease.

Related Publications

Physical Functioning

Mobility and physical functioning are important aspects of good health in late life. However, maintaining mobility and keeping physically active usually requires good vision. Results from Dr. Swenor’s work has identified vision loss as an important factor contributing to walking difficulties and mobility disability in late life, and highlight the need to address the physical consequences of vision loss in older adults.

Related Publications

Reading

Reading difficulty is a common complaint among individuals with visual impairments, including older adults, resulting from age-related macular degeneration and glaucoma. Working with Dr. Pradeep Ramulu, Dr. Swenor has studied sustained reading speed, a measure of reading difficulty, as well as examined the role of comprehension and cognitive function on sustained reading speeds in visually impaired older adults.

Related Publications

Frailty

Frailty is a geriatric syndrome defined as a vulnerability to negative health outcomes, and is thought to result from dysregulation across multiple physiological systems. Assessing frailty in older adults can help identify individuals at risk of falls, hospitalization, worsening disability, and mortality. Dr. Swenor and her are examining the relationship between visual impairment and frailty, and aims to determine if visually impaired older adults are at increased risk of developing frailty, as well as determine if being both visually impaired and frail puts older adults at greater risk of negative health outcomes.

Related Publications

Dual Sensory Impairment

Dr. Swenor and her research group are examining how dual sensory impairment – defined as concurrent vision and hearing impairments – affects health and aging. This research is a joint collaboration with investigators at the Johns Hopkins Cochlear Center for Hearing and Public Health.

Related Publications


Access to Care

Access to health care is an important component of aging well. Dr. Swenor and team aims to characterize and ultimately reduce disparities in eye care and healthcare for individuals with visual impairments. This includes collaborating with researchers from WIlmer Eye Institute's Vision Rehabilitation department to examine utilization of low vision rehabilitation services, which are critical to maintaining or enhancing the functioning of individuals with chronic visual impairment.

Related Publications


Disability Inclusion

Driven by her own experience with a disability, Dr. Swenor’s research and advocacy include efforts to enhance disability inclusion. Persons with disabilities offer a unique and valuable perspective that can drive scientific innovation and advance patient care, yet this group is often absent from research and medical settings. To change this, Dr. Swenor is providing evidence of this underrepresentation and identifying barriers to inclusion for persons with disabilities across the academic pipeline, from students to faculty.

Related Publications


Ongoing Studies

Sense Matters

The SENSE Matters study aims to understand across-study variation in methods used to collect and analyze cognitive data in older adults with hearing or vision impairment. Eligible, longitudinal cohort studies will be systematically identified from a literature review and methods of collecting and analyzing cognitive data among older adults will be compared using responses to surveys sent to each cohort study. Ultimately, this study seeks to pioneer the development of standardized methods to collect cognitive data in older adults with sensory impairment. The SENSE Matters study is funded by National Institute on Aging grant R21AG060243.

Learn more about SENSE Matters.


In the News

Focus On Eye Health National Summit: Losing Vision and Gaining Perspective (Video) - Prevent Blindness (July 2019)
What Medicine Can Learn From Doctors and Researchers with Disabilities - NPR (June 2019)
High Sights for Low Vision - Hopkins Medicine (Winter 2019)
Exploring links between senses and cognitive health - Science Daily (Sept 2018)
Study suggests maintaining good vision may stave off cognitive decline - National Eye Institute (Sept 2018)


Our Team

Principal Investigator

Photo of Dr. Bonnielin Swenor, M.P.H., Ph.D.

Swenor, Bonnielin, M.P.H., Ph.D.

Associate Professor of Ophthalmology
Core Faculty Member at the Johns Hopkins University Center on Aging and Health
Expertise, Disease and Conditions: Epidemiology, Ophthalmology
Research Interests: Ophthalmology, Visual impairment, Low Vision, Aging, Epidemiology
 

Postdoctoral research fellows

Lamma Assi
Fahd Naufal
Niranjani Nagarajan
Ahmed Shakarchi

Varshini Varadaraj

Medical students

Sophie Gu
Moon Jeong Lee
Priyanka Kumar

Master of Public Health Students

Mina Motaghi
Niranjani Nagarajan
Yi Sun

Undergraduate Students

Yunmeng Wang
Annie Zhang