Pérès Karine, Matharan Fanny, Daien Vincent, Nael Virginie, Edjolo Arlette, Bourdel-Marchasson Isabelle, Ritchie Karen, Tzourio Christophe, Delcourt Cécile, Carrière Isabelle
Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France.
Am J Public Health. 2017 Apr;107(4):564-569. doi: 10.2105/AJPH.2016.303631. Epub 2017 Feb 16.
To investigate the relationship between vision and disability in the elderly.
We used a baseline visual indicator (combining near acuity with Snellen equivalent < 20/30 and self-reported distance visual loss) to explore the association between visual loss and subsequent disability (mobility, instrumental activities of daily living [IADLs], ADLs, and participation restriction) from 1999 to 2007 in 8491 elderly participants of the French Three-City Cohort (Bordeaux, Dijon, and Montpellier).
In multiadjusted analyses, near visual impairment, alone or associated with distance visual function loss, was associated with greater risk of developing ADL limitations (P = .027), IADL limitations (P = .002), and participation restriction (P < .001), but not mobility (P = .848). The disabling impact of visual loss was significant for 11 of the 15 activities, when analyzed one by one.
Both near and distance visual loss was associated with greater functional decline over time, and the combination of the two could be even worse. Public Health Implications. In the context of rapid aging of the population, maintaining good vision in the elderly represents a promising prevention track, visual impairment being common in the elderly, largely undermanaged, and mostly reversible. Further research, especially trials, is necessary to estimate the public health impact of such interventions.
研究老年人视力与残疾之间的关系。
我们使用一种基线视觉指标（将近视力与斯内伦等效视力<20/30以及自我报告的远距离视力丧失相结合），探讨1999年至2007年期间法国三市队列（波尔多、第戎和蒙彼利埃）的8491名老年参与者中视力丧失与随后残疾（行动能力、日常生活工具性活动[IADL]、日常生活活动[ADL]和参与受限）之间的关联。
在多因素调整分析中，单纯的近视力损害或与远距离视觉功能丧失相关的近视力损害，与发生ADL受限（P = 0.027）、IADL受限（P = 0.002）和参与受限（P < 0.001）的风险增加相关，但与行动能力无关（P = 0.848）。逐一分析时，视力丧失对15项活动中的11项产生的致残影响显著。
近视力和远距离视力丧失均与随时间推移功能下降加剧相关，两者结合可能更糟。对公共卫生的影响。在人口快速老龄化的背景下，保持老年人的良好视力是一条有前景的预防途径，因为视力损害在老年人中很常见，大多未得到妥善管理，且大多是可逆转的。有必要进行进一步研究，尤其是试验，以评估此类干预措施对公共卫生的影响。
