Caregivers take Notice: The Gift of Reading

This is the year of the tablet, David Pogue of The Times has told us, and that may be good news for seniors who open holiday wrappings to find one tucked inside. They see better with tablets’ adjustable type size, new research shows. Reading becomes easier again.

This may seem obvious — find me someone over 40 who doesn’t see better when fonts are larger — but it’s the business of science to test our assumptions.

This article was published by The New York Times blog “The New Old Age” on December 12th, 2012.  To see this article and other related articles on The New York Times blog “The New Old Age” website, please click here

Dr. Daniel Roth, an eye specialist and clinical associate professor at the Robert Wood Johnson Medical School in New Brunswick, N.J., offered new evidence of tablets’ potential benefits last month at the annual meeting of the American Academy of Ophthalmology.

His findings, based on tests conducted with 66 adults age 50 and over: older people read faster (a mean reading speed of 128 words per minute) when using an iPad, compared to a newspaper with the same 10-point font size (114 words per minute).

When the font was increased to 18 points — easy to do on an iPad — reading speed increased to 137 words per minute.

“If you read more slowly, it’s tedious,” Dr. Roth said, explaining why reading speed is important. “If you can read more fluidly, it’s more comfortable.”

What makes the real difference, Dr. Roth theorizes, is tablets’ illuminated screen, which heightens contrast between words and the background on which they sit.


Contrast sensitivity — the visual ability to differentiate between foreground and background information — becomes poorer as we age, as does the ability to discriminate fine visual detail, notes Dr. Kevin Paterson, a psychologist at the University of Leicester, who recently published a separate study on why older people struggle to read fine print.

“There are several explanations for the loss of sensitivity to fine detail that occurs with older age,” Dr. Paterson explained in an e-mail. “This may be due to greater opacity of the fluid in the eye, which will scatter incoming light and reduce the quality of the projection of light onto the retina. It’s also hypothesized that changes in neural transmission affect the processing of fine visual detail.”

Combine these changes with a greater prevalence of eye conditions like macular degeneration and diabetic retinopathy in older adults, and you get millions of people who cannot easily do what they have done all their lives — read and stay connected to the world of ideas, imagination and human experience.

“The No. 1 complaint I get from older patients is that they love to read but can’t, and this really bothers them,” Dr. Roth said. The main option has been magnifying glasses, which many people find cumbersome and inconvenient.

Some words of caution are in order. First, Dr. Roth’s study has not been published yet; it was presented as a poster at the scientific meeting and publicized by the academy, but it has not yet gone through comprehensive, rigorous peer review.

Second, Dr. Roth’s study was completed before the newest wave of tablets from Microsoft, Google, Samsung and others became available. The doctor made no attempt to compare different products, with one exception. In the second part of his study, he compared results for the iPad with those for a Kindle. But it was not an apples to apples comparison, because the Kindle did not have a back-lit screen.

This section of his study involved 100 adults age 50 and older who read materials in a book, on an iPad and on the Kindle. Book readers recorded a mean reading speed of 187 words per minute when the font size was set at 12; Kindle readers clocked in at 196 words per minute and iPad readers at 224 words per minute at the same type size. Reading speed improved even more drastically for a subset of adults with the poorest vision.

Again, Apple’s product came out on top, but that should not be taken as evidence that it is superior to other tablets with back-lit screens and adjustable font sizes. Both the eye academy and Dr. Roth assert that they have no financial relationship with Apple. My attempts to get in touch with the company were not successful.

A final cautionary note should be sounded. Some older adults find digital technology baffling and simply do not feel comfortable using it. For them, a tablet may sit on a shelf and get little if any use.

Others, however, find the technology fascinating. If you want to see an example that went viral on YouTube, watch this video from 2010 of Virginia Campbell, then 99 years old, and today still going strong at the Mary’s Woods Retirement Community in Lake Oswego, Ore.

Ms. Campbell’s glaucoma made it difficult for her to read, and for her the iPad was a blessing, as she wrote in this tribute quoted in an article in The Oregonian newspaper:

To this technology-ninny it’s clear
In my compromised 100th year,
That to read and to write
Are again within sight
Of this Apple iPad pioneer

Caregivers might be delighted — as Ms. Campbell’s daughter was — by older relatives’ response to this new technology, a potential source of entertainment and engagement for those who can negotiate its demands. Or, they might find that old habits die hard and that their relatives continue to prefer a book or newspaper they can hold in their hands to one that appears on a screen.

Which reading enhancement products have you used, and what experiences have you had?

© The New York Times