Abstract
Purpose :
To investigate the cross-sectional associations between components of the visual function system (VFS) and functional health outcomes, in multi-ethnic Asians aged ≥60 years.
Methods :
We included individuals from The PopulatION HEalth and Age-Related SEnsory Decline PRofilE (PIONEER), a cross-sectional population-based study of Singaporean Chinese, Malays, and Indians aged ≥60 years. VFS assessments comprised visual acuity (VA, logarithm of the minimum angle of resolution (LogMAR)), contrast sensitivity (CS, Pelli-Robson), and depth-perception (DP, Frisby). Functional health outcomes included instrumental activity of daily living (IADL, using Lawton Scale), mobility (via 4m-walking speed), and self-reported falls in the last 12 months. VFS impairments in the better eye were defined as follows: presenting visual impairment (PVI) as presenting VA worse than 6/12 (logMAR > 0.3); CS impairment (CSI) as CS <1.55 log CS; and DP impairment (DPI) as binocular DP≥150 arc sec. Logistic regression models were used to determine the independent relationship between the VFS and functional health outcomes.
Results :
Of the 1,782 participants (mean age [SD]: 72.7 [8.2] years; 54.7% females), 303 (17.0%), 363 (20.4%), and 502 (28.2%) had PVI, CSI and DPI, respectively. Slow gait speed (<0.8m/s), low IADL (IADL score <24 for women and <15 for men) and at least one fall, was present in 662 (37.9%), 264 (17.6%) and 289 (19.2%) individuals, respectively. In multivariable-adjusted analyses including all VFS impairments simultaneously, PVI was associated with higher odds of poor IADL (odds ratio [OR]=1.53, 95% confidence interval [CI]: 1.06-2.21), while CSI was associated with an increased likelihood of poor IADL (OR=1.92, 95% CI: 1.37-2.69) and slow gait speed (OR=2.15, 95% CI: 1.63- 2.85). In turn, DPI significantly increased the odds of having experienced any falls by over 40% (OR=1.43, 95% CI: 1.06- 1.92).
Conclusions :
CSI and DPI, independent of VA, are associated with a higher risk of poor functional health outcomes. Strategies such as highlighting steps or uneven surfaces may be warranted to potentially reduce the risk of poor functional health in older adults with low vision.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.