Klein Barbara E K, Klein Ronald, Knudtson Michael D
Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53726, USA.
Ophthalmology. 2006 Dec;113(12):2209-12. doi: 10.1016/j.ophtha.2006.04.035. Epub 2006 Sep 25.
To determine whether there is an association between age-related cataract and frailty that persists after controlling for visual acuity (VA) and comorbid conditions.
Cross-sectional.
Two thousand three hundred seventy Beaver Dam Eye Study cohort members at 10-year (third) examination with cataract information. Ninety-nine percent of the population was Caucasian.
Medical history, blood pressures, height, weight, measures of frailty, and lens photographs were obtained during the study evaluation. Lens photographs were graded according to standardized protocols.
Four of frailty (gait time, peak expiratory flow rate, handgrip strength, chair stand) and an index combining all 4 measures.
After controlling for age, age squared, comorbidity index, pack-years, sedentary lifestyle, education, and VA, nuclear cataract in women was not associated significantly with any frailty measures; in men, nuclear cataract was associated with slower gait time (P = 0.01) and a poorer frailty index score (P = 0.01) in multivariable analyses. Cortical cataract was associated in women with a lower peak expiratory flow rate (P<0.01) and in men with weaker handgrip strength (P = 0.02) and a poorer frailty index score (P</=0.01) in multivariable analyses. Posterior subcapsular cataract in women was associated significantly with a lower peak expiratory flow rate (P = 0.01). Nuclear and cortical cataract add significant information in explaining frailty index scores in men.
Three common types of age-related cataract are associated with some measures of frailty independent of VA and systemic comorbidities. It is possible that age-related cataract may be an indicator of general functional decline in older adults.
确定在控制视力(VA)和共病情况后,年龄相关性白内障与衰弱之间是否存在关联。
横断面研究。
2370名参加比弗迪尔姆眼科研究队列的成员,在10年(第三次)检查时有白内障信息。99%的人群为白种人。
在研究评估期间获取病史、血压、身高、体重、衰弱指标以及晶状体照片。晶状体照片根据标准化方案进行分级。
四项衰弱指标(步态时间、呼气峰值流速、握力、从椅子上站起)以及综合所有四项指标的指数。
在控制年龄、年龄平方、共病指数、吸烟包年数、久坐生活方式、教育程度和视力后,女性核性白内障与任何衰弱指标均无显著关联;在男性中,多变量分析显示核性白内障与较慢的步态时间(P = 0.01)和较差的衰弱指数评分(P = 0.01)相关。皮质性白内障在女性中与较低的呼气峰值流速相关(P<0.01),在男性中与较弱的握力相关(P = 0.02)以及在多变量分析中与较差的衰弱指数评分相关(P≤0.01)。女性后囊下白内障与较低的呼气峰值流速显著相关(P = 0.01)。核性和皮质性白内障在解释男性衰弱指数评分方面增加了重要信息。
三种常见的年龄相关性白内障类型与一些独立于视力和全身共病情况的衰弱指标相关。年龄相关性白内障可能是老年人总体功能下降的一个指标。