Visual Function, Physical Function, and Activities of Daily Living in Two Aging Communities

Abstract

Purpose : Visual impairment (VI) and physical limitations are common in the older population. However, their associations are yet to be explored in adults 70 years and older. We report the distribution of VI, contrast sensitivity impairment (CSI) and their associations with physical disability and quality of life (QoL) in an aging population-based sample.

Methods : In this cross-sectional analysis, participants from the Atherosclerosis Risk In Community cohort were recruited for the Eye Determinants of Cognition Study, including 494 black participants from Jackson, MS and 558 white participants from Washington County, MD. Distance presenting, corrected, and near VI was categorized as mild (20/40-20/60) and moderate or greater (<20/60) using better-eye acuity. CSI was categorized as moderate (1.04-1.50 logCS) and severe or profound (<1.04 logCS). Physical ability was assessed using the short physical performance battery (SPPB) and self-reported functional limitations, difficulty with activity of daily living (ADL) and instrumental ADL (IADL), physical QoL scores were derived from Short Form 12v2 Health Survey. Associations of VI, CSI with physical abilities were explored overall and by community.

Results : Mean age was 80 years, 63% were female, and 15% had distance presenting VI. Corrected VI (2.6% vs 5.5%), near VI (19% vs 38%), and CSI (70% vs 80%) were less prevalent in Jackson (all P<0.05). Overall, moderate or greater near VI was associated with higher rates of IADL disabilities (prevalence ratios [PR]=1.54, 95% confidence interval [CI]: 1.18-2.02) and lower SPPB scores. Similarly, significant associations were found between moderate or greater presenting VI with functional limitation and lower SPPB scores; and between CSI with functional limitation, and lower physical QoL and SPPB scores. Stratified analysis showed stronger associations in Jackson than Washington County, e.g., Jackson participants with severe & profound CSI showed higher rates of IADL disabilities (PR_Jackson=2.11, 95% CI: 1.13-3.95; PR_Washington=1.15, 95%CI: 0.50-2.66).

Conclusions : Distance VI, near VI and CSI were associated with poor physical function and reduced QoL. These associations should be understood in the context of the communal differences. They call for public health endeavors to address VI and CSI to optimize physical ability and QoL in the older adults with poor vision.

This is a 2021 ARVO Annual Meeting abstract.