Abstract
Purpose :
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.
Methods :
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.
Results :
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.
Conclusions :
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.