Abstract
Purpose :
To determine the association between functional metrics with self-reported quality of life (QOL) in glaucoma.
Methods :
Participants with glaucoma or suspected glaucoma were enrolled in this observational cohort study. Fear of falling (FOF) and Glaucoma Quality of Life-15 (GQL-15) were collected via questionnaire and Rasch analyzed to create an ability score. Participants were classified into fallers and non-fallers based on prospective data collected over the first study year. Medical grade omnidirectional accelerometer, GAITRite Electronic Walkway, and Opal Kinematic systems were used to characterize average daily steps, gait (cadence, base of support, stride length and velocity) and balance (RMS sway, jerk, total sway, ellipse sway), respectively. The association between these functional metrics and GQL-15 were assessed using linear regression models. Models were controlled for age, race, gender, polypharmacy, comorbidities, and integrated visual field sensitivities.
Results :
Of the 245 participants, 51.4% were males and 28.6% identified as African American. Mean age was 70.6±7.6 years. GQL-15 was significantly worse with increased fear of falling (β=0.41 logit/logit of FOF) and poor balance (RMS sway: β=0.30 logit/z-score unit; jerk: β=0.87 logit/z-score unit; total sway: β=0.58 logit/z-score unit; and ellipse sway: β=0.28 logit/z-score unit; all p≤0.006, Table 1). Associations between worse GQL-15 with increased fear of falling and poor balance (total sway and ellipse sway) persisted even after adjusting for visual field sensitivity (all p≤0.04). Models including visual field sensitivity, baseline characteristics, and both combined explained 18.9%, 6.5% and 25.2% of variability in QOL, respectively. A multivariable model constructed by stepwise backward selection including functional metrics adjusted for baseline characteristics and visual field sensitivity explained 51.4% of variability in QOL.
Conclusions :
Functional metrics are associated with quality of life independent of disease severity and demographic features. However, a good deal of variability in quality of life remains unexplained, even after accounting for functional metrics and visual function, suggesting that both are important in understanding the impact of disease.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.