Abstract
Purpose :
Near vision impairment (NVI)has been associated with diminished function across multiple health-related domains- physical, cognitive, and psychosocial. However, there are no data examining the impact of NVI on frailty, a condition increasingly recognized as an important predictor of adverse health outcomes in older adults. Here, we examine the association between NVI (both presenting NVI and self-reported NVI) and frailty. We hypothesize that older adults with NVI are more likely to be frail than those without NVI.
Methods :
We analyzed data from participants ≥60 years from the 1999-2002 cycles of National Health and Nutrition Examination Survey (NHANES). Presenting NVI (PNVI) was defined as near acuity worse than 20/40. Self-reported NVI (SNVI) was defined as self-reported difficulty with near vision tasks. Participants were classified as frail (3 or more criteria) and pre-frail (1 or 2 criteria) based on 5 criteria:(1) report of poor endurance and energy, (2) report of weakness, (3) report of low physical activity, (4) shrinking (reported ≥10 lb or ≥5% unintentional weight loss over 1 year or body mass index<18.5), and (5) slowness (slowest 20% on 20 ft walk). Probability weighted (survey weights x inversepropensity scores)multinomial logistic regression models were used to examine associationsof PNVI and SNVI with frailty, adjusting for age (cubic spine), sex, race, education, income, smoking, diabetes, and total number of comorbidities.
Results :
In this population of 2,663 older adults, 18% had PNVI (n=487), 10% had SNVI (n=266), and 4% had both PNVI and SNVI (n=106). As compared to those without PNVI, participants with PNVI were more likely to be prefrail (OR=1.6; 95% CI: 1.1,2.6) and frail (OR=3.3; 95% CI: 1.5,7.0), (reference group was non-frail). As compared to those without SNVI, participants with SNVI were also more likely to be prefrail (OR=2.4; 95% CI: 1.2,4.8) and frail (OR=4.7; 95% CI: 1.6,14.1), (reference group was non-frail). When presenting near visual acuity was assessed on a continuous scale, each one-line decrement in near acuity was associated with greater odds of prefrailty (OR=1.3 per 0.1 logMAR decrement; 95% CI: 1.1,1.4), and frailty (OR=1.4 per 0.1 logMAR decrement; 95% CI: 1.1,1.8).
Conclusions :
Older adults with PNVI and SNVI were more likely to be pre-frail or frail than those without respective NVI, suggesting that NVI may be an important risk factor for frailty.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.