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Ellen E. Freeman, Mihaela Popescu, Hélène Boisjoly, Marie-Jeanne Kergoat, Jacqueline Rousseau, Solmaz Moghadaszadeh, Fawzia Djafari, Heidi Schmaltz; Age-related Eye Disease And Frailty In Older Adults. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5456.
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To examine the extent of frailty in older patients with age-related macular degeneration (AMD), glaucoma, or Fuchs corneal dystrophy as compared to a control group of older adults with good vision. Frailty is a geriatric syndrome caused by impairments in multiple inter-related systems, leading to increased vulnerability to stressors, decreased homeostatic reserve and resiliency, and increased risk of adverse health outcomes.
We recruited 306 older patients (76 with AMD, 55 with Fuchs, 89 with glaucoma, and 86 controls) from the ophthalmology clinic of Maisonneuve-Rosemont Hospital (Montreal, Canada) from September 2009 until October 2011. Patients with AMD and Fuchs had to have visual acuity in the better eye of 20/40 or worse while patients with glaucoma had to have visual field mean deviation in their worse eye of at least -4dB. Control patients were recruited from the same clinic and had normal visual acuity and visual field. All patients were 65 years or older. The Edmonton Frail Scale, a validated measure of frailty with a range from 0 to 17, was administered. The Geriatric Depression Scale and the Mini-Mental State Examination Blind Version were given. Visual acuity, contrast sensitivity, and visual field were measured and the medical record was reviewed. Linear regression was used to control for demographics (age, gender, race), health factors (depression, comorbidity, cognition, cataract), and social support.
Patients with glaucoma and Fuchs corneal dystrophy had scores on the Edmonton Frail Scale that were 1.03 and 1.00 points higher on average than control patients respectively after adjustment (P<0.01). Patients with AMD had scores that were 0.70 points higher on average than controls although this was not a statistically significant difference (P=0.06). Other factors related to scores on the Edmonton Frail Scale included older age, non-white race, lower cognitive scores, depressive symptoms, higher comorbidity scores, and lower social support (P<0.01).
Glaucoma and Fuchs corneal dystrophy were associated with higher frailty scores in older adults. Longitudinal data examining the mediators of these pathways should be collected.
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