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Visual Impairment and Frailty: Examining an understudied relationship.

Abstract

BACKGROUND

Older adults with visual impairments are at increased risk of negative health outcomes. Here, we investigate the association between visual impairment and frailty.

METHODS

Cross-sectional and longitudinal relationships between visual impairment (distance visual acuity) and frailty (frailty phenotype criteria) were examined using data from the National Health and Nutrition Examination Survey (NHANES, 1999-2002, ≥60 years) and the Women's Health and Aging Studies (WHAS III). Imbalance of potential confounders, particularly age, was addressed using propensity score-based adjustment. Multinomial logistic regression determined the odds of prefrailty/frailty at baseline in NHANES and ordinal logistic regression examined the odds of baseline and incident frailty over 3 years in WHAS III after adjustment for confounders and probability weighting (survey weights x inverse propensity scores).

RESULTS

In NHANES (n=2,639, 9% vision impairment), participants with visual impairment were more likely to be prefrail (OR=3.2; 95% CI: 1.9-5.3) and frail (OR=3.7; 95% CI: 1.5-9.2) than those without visual impairment. In WHAS III (n=634, 26% mild, 37% moderate/severe vision impairment), participants with mild and moderate/severe vision impairment were more likely to be frail (OR=2.0; 95% CI: 1.5-2.5; OR=5.5; 95% CI: 4.2-7.2, respectively). A one-line worse visual acuity (0.1 logMAR increase) was associated with greater odds of frailty (OR=1.5; 95% CI: 1.4-1.7). Of those non-frail at baseline (n=549), moderate/severe visual impairment and one-line worse visual acuity was associated with greater odds of incident frailty (OR=3.5; 95% CI: 1.4-8.4; OR=1.3; 95% CI: 1.1-1.5, respectively) over 3 years.

CONCLUSIONS

Visual impairment may be an important, yet understudied risk factor for frailty.

Authors+Show Affiliations

Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31419280

Citation

Swenor, Bonnielin K., et al. "Visual Impairment and Frailty: Examining an Understudied Relationship." The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 2019.
Swenor BK, Lee MJ, Tian J, et al. Visual Impairment and Frailty: Examining an understudied relationship. J Gerontol A Biol Sci Med Sci. 2019.
Swenor, B. K., Lee, M. J., Tian, J., Varadaraj, V., & Bandeen-Roche, K. (2019). Visual Impairment and Frailty: Examining an understudied relationship. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, doi:10.1093/gerona/glz182.
Swenor BK, et al. Visual Impairment and Frailty: Examining an Understudied Relationship. J Gerontol A Biol Sci Med Sci. 2019 Aug 16; PubMed PMID: 31419280.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Visual Impairment and Frailty: Examining an understudied relationship. AU - Swenor,Bonnielin K, AU - Lee,Moon J, AU - Tian,Jing, AU - Varadaraj,Varshini, AU - Bandeen-Roche,Karen, Y1 - 2019/08/16/ PY - 2019/03/30/received PY - 2019/8/17/entrez PY - 2019/8/17/pubmed PY - 2019/8/17/medline KW - frailty KW - risk factors KW - sensory KW - visual impairment JF - The journals of gerontology. Series A, Biological sciences and medical sciences JO - J. Gerontol. A Biol. Sci. Med. Sci. N2 - BACKGROUND: Older adults with visual impairments are at increased risk of negative health outcomes. Here, we investigate the association between visual impairment and frailty. METHODS: Cross-sectional and longitudinal relationships between visual impairment (distance visual acuity) and frailty (frailty phenotype criteria) were examined using data from the National Health and Nutrition Examination Survey (NHANES, 1999-2002, ≥60 years) and the Women's Health and Aging Studies (WHAS III). Imbalance of potential confounders, particularly age, was addressed using propensity score-based adjustment. Multinomial logistic regression determined the odds of prefrailty/frailty at baseline in NHANES and ordinal logistic regression examined the odds of baseline and incident frailty over 3 years in WHAS III after adjustment for confounders and probability weighting (survey weights x inverse propensity scores). RESULTS: In NHANES (n=2,639, 9% vision impairment), participants with visual impairment were more likely to be prefrail (OR=3.2; 95% CI: 1.9-5.3) and frail (OR=3.7; 95% CI: 1.5-9.2) than those without visual impairment. In WHAS III (n=634, 26% mild, 37% moderate/severe vision impairment), participants with mild and moderate/severe vision impairment were more likely to be frail (OR=2.0; 95% CI: 1.5-2.5; OR=5.5; 95% CI: 4.2-7.2, respectively). A one-line worse visual acuity (0.1 logMAR increase) was associated with greater odds of frailty (OR=1.5; 95% CI: 1.4-1.7). Of those non-frail at baseline (n=549), moderate/severe visual impairment and one-line worse visual acuity was associated with greater odds of incident frailty (OR=3.5; 95% CI: 1.4-8.4; OR=1.3; 95% CI: 1.1-1.5, respectively) over 3 years. CONCLUSIONS: Visual impairment may be an important, yet understudied risk factor for frailty. SN - 1758-535X UR - https://www.unboundmedicine.com/medline/citation/31419280/Visual_Impairment_and_Frailty:_Examining_an_understudied_relationship L2 - https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glz182 DB - PRIME DP - Unbound Medicine ER -