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Enrique O Graue-Hernandez, Jesus Arrieta-Camacho, Roberto Castrejon-Perez, Aida Jimenez-Corona; Impact of cataract surgery on pre-frailty and frailty among older patients from a specialized hospital in Mexico City. Invest. Ophthalmol. Vis. Sci. 2017;58(8):777.
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© ARVO (1962-2015); The Authors (2016-present)
Frailty is a highly prevalent geriatric syndrome associated with morbidity, risk of falls, disability, hospitalization, and mortality. The aim of this study was to evaluate the impact of cataract surgery on pre-frailty and frailty among patients 50 years and older.
A longitudinal study was conducted comprising 185 patients 50 years and older with clinically significant cataract who were evaluated before and one month apart from the cataract surgery. Patients had a complete ophthalmic examination. A standardized questionnaire screening for frailty was applied; it included five components: weakness, slowness, fatigue, low physical activity, and weight loss. Pre-frailty was defined as presence of 1 to 2 components; frailty as presence of ≥3 components. The Hospital Anxiety and Depression Scale (HADS) questionnaire was also used, which identifies anxiety and depression symptoms. All analyses were performed with Stata 14.
Of 185 patients (120 women and 65 men; mean age 71.7 years [s.d. 10]; visual acuity worse than 20/200), 110 were pre-frail and 16 were frail. Overall prevalence of frailty and pre-frailty was 8.65% (95%CI 5.3-13.7) and 59.5% (95%CI 52.2-66.4), respectively. Prevalence of frailty was higher in women than in men (13% and 0%, respectively); in patients with anxiety than in those without (30% and 6.1%, respectively); and in patients with depression than in those without (23.8% and 6.7%, respectively). Prevalence of pre-frailty was higher in patients with anxiety than in those without (65.0% and 58.8%, respectively). One month after cataract surgery, 68.8% of those with frailty before surgery reversed to a status of pre-frailty and 6.4% remained frail; 20.9% of those with pre-frailty before surgery reversed to a non-frail status, 72.2% remained with pre-frailty, and 6.4% progressed to frailty. Finally, the likelihood of reversal of pre-frailty (38%) and frailty (31%) was higher in those without signs of anxiety/depression compare with patients who these conditions.
Cataract surgery had a high impact on reversal of pre-frailty and frailty in a short follow-up of older patients. Psychological conditions, such as anxiety and depression, were associated with lower reversal of pre-frailty and frailty. A multidisciplinary management of these patients should thus be implemented.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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