Abstract
Abstract: :
Purpose:To investigate the associations of measures of frailty to prevalent age–related maculopathy (ARM). Methods: Time to walk a measured course (gait–time), handgrip strength, peak expiratory flow rate, ability to stand from a sitting position without using arms, self–reported comorbidity, and ARM were assessed using standardized protocols at the third examination (1998–2000) of the Beaver Dam Eye Study cohort (n=2962). Characteristics of drusen and other lesions typical of age–related maculopathy were determined by grading stereoscopic color fundus photographs using the Wisconsin Age–Related Maculopathy Grading System. A frailty index combining poor function for each measure of frailty was devised. Results: Measures of frailty were significantly associated with age. While controlling for age, smoking, and the number of comorbid conditions, weaker handgrip strength was associated with early (Odds ratio (OR) per 10 Kg decrease of handgrip strength was 1.28, Confidence Interval [CI] 1.08, 1.52, P=0.004) and late ARM (OR 1.55, 95% CI 1.02, 2.36, P=0.04) in men but not women (OR 0.98, 95% CI 0.76, 1.26, P=0.85 for early ARM and OR 1.17, 95% CI 0.59, 2.33, P=0.66 for late ARM). There were borderline statistically significant associations of inability to stand from a sitting position in one try with early ARM (OR 1.51 95% CI 0.99, 2.32, P=0.06) and frailty index with late ARM (OR 1.36, 95% CI 0.94, 1.98, P=0.10) in women but not in men (OR 1.04, 95% CI 0.61, 1.78, P=0.89 for inability to stand and early ARM and OR 1.03, 95% CI 0.68, 1.56, P=0.89 for the frailty index with late ARM). Controlling for specific comorbid conditions, physical activity or body mass index did not affect these associations. There were no associations of gait–time or peak expiratory flow rate with either prevalent early or late ARM. Conclusions: In summary, the data from Beaver Dam show a weak association of handgrip strength with ARM in men. Few other associations were found. While these data suggest that ARM is more likely due to a disease process, albeit age–related, than to biological aging, as reflected by measures of frailty, longitudinal follow–up in other large population–based studies is necessary to further study these relationships.
Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment • aging