Visual Impairment and Frailty: Examining an Understudied Relationship. (16th August 2019)

• Record Type: Journal Article
• Authors: Swenor, Bonnielin K; Lee, Moon J; Tian, Jing; Varadaraj, Varshini; Bandeen-Roche, Karen
• Editors: Magaziner, Jay
• Is Part Of: Journals of gerontology. Volume 75:Number 3(2020)
• Page Start: 596
• Page End: 602
• Publication Date: 2019-08-16
• Subjects: Visual impairment -- Frailty -- Sensory -- Risk factors; Geriatrics -- Periodicals; Gerontology -- Periodicals; 618.97
• DOI: 10.1093/gerona/glz182
• Languages: English
• ISSNs: 1079-5006

Abstract

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 and 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 × inverse propensity scores). Results: In NHANES ( n = 2, 639, 9% vision impairment), participants with visual impairment were more likely to be prefrail (odds ratio [OR] = 3.2; 95% confidence interval [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 = 796, 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.