Visual Impairment and Frailty: Examining an understudied relationship.
Older adults with visual impairments are at increased risk of negative health outcomes. Here, we investigate the association between visual impairment and frailty.
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).
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.
Visual impairment may be an important, yet understudied risk factor for frailty.