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Jian-Yu E, Aleksandra Mihailovic, Catalina Garzon, Jennifer Schrack, Tianjing Li, Sheila K West, David S. Friedman, Laura N. Gitlin, Pradeep Y Ramulu; Global Positioning System (GPS)-tracked physical activity in glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1581.
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Physical activity is a central feature of well-being and an essential component of quality of life in older adults, particularly those with vision loss. To optimize physical activity and safety, it is important to understand where persons with visual impairment perform their activities and which activity locations are safe. We performed a prospective cohort study to examine the association of visual field (VF) damage on physical activity away-from-home, per away-from-home excursion, and at home in glaucoma patients.
We analyzed three years (2013-2015) of data from a well-established cohort of community-dwelling older people with glaucoma (N=229, Table 1). The severity of VF damage was defined as average sensitivity within the integrated VF (IVF). Participants wore accelerometers and GPS trackers for seven days to measure physical activity and characterize activity location. Multivariable negative binomial regressions were used to test whether away-from-home activity per day, activity per away-from-home excursion, and at-home activity per day varied by the severity of VF damage. Covariates included age, race, sex, living arrangement, employment, education, comorbidity, polypharmacy, and cognitive function.
Each 5-dB decrement in IVF sensitivity was associated with a lower amount of away-from-home activity per day [18% less Moderate & Vigorous Physical Activity (MVPA) minutes/day, 16% less active minutes/day (95% CI, 0.75, 0.93) and 17% fewer steps/day (95% CI, 0.74, 0.93)] (Table 2), and physical activity per away-from-home excursion [20% less MVPA minutes/excursion (95% CI, 0.65, 0.98), 19% less active minutes/excursion (95% CI, 0.71, 0.92) and 20% fewer steps/excursion (95% CI, 0.72, 0.90)]. However, worse IVF sensitivity was not associated with measures of at home activity (MVPA minutes/day, active minutes/day, and steps/day), time spent at or away from home, or excursions/week (p>0.1 for all).
Restriction of physical activity in more severe glaucoma patients results mostly from activity restriction outside home environment. These findings highlight the importance of maintaining a safe home environment and increasing confidence to perform activity, particularly high-intensity activity, when leaving the home amongst patients with glaucoma. Further research is warranted to define specific environmental features that may improve safety and functionality in visually impaired population.
This is a 2021 ARVO Annual Meeting abstract.
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