Associations of the Deterioration in Visual Impairment and Visual Function Components with Dysmobility Syndrome: Findings from The Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study

Abstract

Purpose : Dysmobility syndrome (DS), a composite health index of morbid health, is associated with poor health outcomes and mortality in elderly individuals. However, data linking impairments in the aging visual function system with DS are currently lacking. We therefore explored the associations of any visual impairment (VI), abnormal contrast sensitivity (CS) and stereoacuity (SA), individually and in combination, with DS in a population-based study of elderly Asian adults.

Methods : We included participants (median [IQR] age: 70 [12 years]; 50.6% female) from the PIONEER baseline phase. DS was defined as having ≥3 of the following factors: osteoporosis (hip and/or spine T-score ≤2.5), any falls in the past year, DXA-assessed low muscle mass (appendicular lean mass <7kg/m² [men]; <5.4kg/m² [women]), slow gait speed (<1.0m/s), low grip strength (hand-held dynamometer <28kg [men]; <18kg [women]), and high total percent body fat (>33% [men]; >43% [women]). Any VI was defined as having presenting distance visual acuity ≥0.3 logMAR in any eye. Any CS and binocular SA were defined as <1.55 logCS in any eye and ≥150 arc sec respectively. Multivariable logistic regression examined the association of any VI, CS and SA individually and in combination with DS, adjusted for known confounders.

Results : A total of 900 (59.4%), 597 (39.4%), 664 (43.8%), and 411 (27.1%) participants had any DS, VI, CS and SA, respectively. There was no independent association between any individual visual factors and DS, although those with impairments in all 3 visual factors had greater odds (OR=1.84, 95% CI=1.22-2.76) of having DS compared to those with no impairment. The marginal effect contribution of each individual factor to the 3-factors combination were 50.2%, 57.2% and 74.7% for VI, CS and SA, respectively. Moreover, the independent contribution of the triad presence on the likelihood of DS were ~10%, after accounting for significant confounders.

Conclusions : Given the increased odds of DS in those with the triad presence of visual function impairments, routine eye screenings and interventions to mitigate the impact of concomitant visual function decrements may be warranted to reduce the associated adverse health risks of DS.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.