Reading Speed and Reading Comprehension in Age-related Macular Degeneration

Abstract

Purpose: To evaluate the impact of age-related macular degeneration (AMD) on short out-loud and sustained silent reading speeds, and reading comprehension.

Design: Prospective, cross-sectional.

Methods: Setting: Wilmer Eye Institute.

Population: Literate, native-English speakers with and without AMD. AMD participants had better-eye visual acuity (VA) <20/32 and >20/100, while controls had binocular VA >20/32.

Procedures: MNRead was used to assess short-duration out-loud reading speed. Sustained silent reading test was used to evaluate sustained silent reading speeds, while reading comprehension was assessed based on silent reading test text.

Outcome measures: MNRead maximum reading speed, sustained-silent reading speed, and comprehension score.

Results: Analyses included 24 AMD patients and 22 controls. In age-adjusted regressions, AMD participants, compared to controls, read 46 words per minute (wpm) slower on MNRead (95% confidence interval [CI]: -66, -26, P < .001), but there was no difference in sustained reading speeds between groups (β = 0.99, 95% CI: -41.8, 43.8, P = .96). In other models, there was a decrement of 12.6 wpm on MNRead per 0.1 worsening logMAR (95% CI: -18.7, -6.6, P < .001), but VA was not associated with a decrement in sustained reading speed (β = -10.1, 95% CI: -22.4, 2.1, P = .10). However, AMD participants had substantially lower comprehension scores than controls (53% vs 85% correct, P < .001), and each 1-line VA decrement was associated with 5.9% lower comprehension score (95% CI: -9.1, -2.7, P = .001).

Conclusions: AMD patients read slower than controls when forced to read out loud. When asked to read silently over a longer duration, both groups read at similar speeds, though AMD patients demonstrated substantially lower comprehension scores, suggesting that they chose to sacrifice comprehension for speed.