Abstract
Purpose :
To investigate if neighborhood factors are associated with physical activity in older adults with visual impairment.
Methods :
Persons with glaucoma or suspected glaucoma had accelerometer-defined physical activity collected over 7-days and summarized as average daily steps and non-sedentary minutes. Census block and tract numbers were utilized to collect the following neighborhood characteristics: Area Deprivation Index, fraction of residents living below the federal poverty line, and average crime rate per 100k people, categorized as low (<2,500), medium (2,500-5,000) and high (>5,000). Based on the integrated visual field (VF) sensitivity, participants were categorized to mild, moderate or severe VF loss from glaucoma. Multivariable negative binomial regression models evaluated the effect of neighborhood factors on physical activity for all participants, and participants stratified by severity of the VF loss.
Results :
The 230 study participants were on average 70 years old; about half were female, and about third Black. Average daily steps and non-sedentary minutes were lower with higher are deprivation index (rate ratio [RR]=0.96 per 1 decile, 95%CI=0.93 to 0.99, p=0.007 and RR=0.96 per 1 decile, 95% CI=0.94 to 0.98, p=0.001, respectively). Average non-sedentary minutes were also lower for those living in areas with higher fraction of residents below the federal poverty line (RR=0.92 per 10% increase, 95% CI=0.85 to 0.98, p=0.02). Both, average daily steps and non-sedentary minutes, also decreased significantly in those with severe VF loss who lived in the areas with higher fraction of residents below the federal poverty line (RR=0.78 per 10% increase, 95% CI=0.63 to 0.96, p=0.02, and RR=0.76 per 10% increase, 95% CI=0.66 to 0.88, p<0.001, respectively). Neither average daily steps nor non-sedentary minutes were associated with crime rates (p>0.11 for all) for the whole group, though much less activity was noted in those living in higher vs. lower crime rate areas amongst participants with severe VF loss (RR=0.32, 95% CI=0.17 to 0.58, p<0.001, and RR=0.36, 95% CI=0.23 to 0.57, p<0.001, respectively).
Conclusions :
Neighborhood characteristics might be important drivers of mobility in glaucoma patients, especially in those with the severe VF loss. Interventions to overcome activity limitations may be particularly important in this group.
This is a 2021 ARVO Annual Meeting abstract.