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Bonnielin K Swenor, Jing Tian, Varshini Varadaraj, Karen Bandeen-Roche; Visual Impairment and Frailty: The Women’s Health and Aging Study (WHAS). Invest. Ophthalmol. Vis. Sci. 2018;59(9):4461.
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To determine if older adults with visual impairment (VI) are at an increased risk of developing frailty compared to older adults without VI.
Participants from the Women’s Health and Aging I and II cohorts (n=796) were included in analyses. Based on presenting visual acuity assessed at baseline, VI was defined as acuity worse than 20/40. Based on five phenotypic criteria- (1) low grip strength (lowest 20% baseline values); (2) report of poor endurance or energy over the past month; (3) slow walking speed (slowest 20% baseline values on 4-meter walk); (4) low physical activity defined using the modified Minnesota Leisure Time Physical Activity Scale; and (5) unintentional weight loss of ≥10% since age 60 or body mass index <18.5- individuals were classified as prefrail or frail if they met 1-2 or 3+ criteria, respectively. Logistic regression was used to determine the relative odds of prefrailty/frailty at baseline, and multinomial logistic regression was used to estimate the relative odds of incident prefrailty/frailty at year 3, for VI vs non-VI. All models were adjusted for age, sex, race, years of education, Mini-Mental State Exam (MMSE) score, report of depressive symptoms, smoking status, diabetes, and number of other comorbid conditions.
In this population, 63% had VI (n=502) at baseline. Compared to those without VI, participants with VI had older age (75 vs 74 years), fewer years of education (11 vs 13 years), a lower MMSE score (28 vs 29), and more comorbidities (3 vs 2 conditions), on average, and were more likely to be black (28% vs 20%), report depressive symptoms (26% vs 11%), be a current smoker (15% vs 8%), and have diabetes (20% vs 8%) (p < 0.001 for all). At baseline, participants with VI had 2.5-fold greater odds of being prefrail (95% CI: 2.2, 2.7) and 8.6-fold greater odds of being frail (95% CI: 6.8, 10.8) than those without VI, after adjusting for age and other confounders. Of those not prefrail/frail at baseline (n=307), VI participants were significantly more likely to develop prefrailty (OR=1.5; 95% CI: 1.4, 1.6) and frailty (OR=1.7; 95% CI: 1.5, 2.0) than those without VI at Year 3 after similar adjustments.
Visually impaired older adults in this study were more likely to be frail and develop frailty than those without vision loss, suggesting that older adults with vision loss at elevated risk of developing frailty.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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