Department of Surgical Ophthalmology, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
J Gerontol A Biol Sci Med Sci. 2023 Oct 28;78(11):2060-2069. doi: 10.1093/gerona/glac225.
To assess the relationship between self-reported and performance-based visual impairment (VI) and lower extremity physical function.
Cross-sectional analysis of 2 219 Health ABC participants who completed vision testing and the Short Physical Performance Battery (SPPB). Linear regression models used either self-reported (weighted visual function question [VFQ] score) or performance-based (visual acuity [VA], log contrast sensitivity [LCS], Frisby stereoacuity [SA]) to predict SPPB or its components-gait speed, chair stands, or standing balance-with and without covariate adjustment.
Mean age was 73.5 years (range 69-80); 52.4% were female and 37.4% African American. All VI measures were strongly associated with SPPB in unadjusted and adjusted models (p < .001). A self-reported VFQ score 1 standard deviation lower than the mean (mean 87.8 out of 100) demonstrated a -0.241 (95% confidence interval [CI]: -0.325, -0.156) adjusted difference in SPPB. After controlling for covariates, VA of <20/40 (41%) demonstrated a -0.496 (-0.660, -0.331) lower SPPB score while SA score>85 arcsec (30%) had a -0.449 (-0.627, -0.271) adjusted SPPB score versus those with better visual function. LCS < 1.55 (28.6%) was associated with a -0.759 (-0.938, -0.579) lower and LCS ≤ 1.30 (8%) with a -1.216 (-1.515, -0.918) lower adjusted SPPB score relative to better LCS. In a final multivariable model containing multiple vision measures, LCS remained independently associated with SPPB and all components, while SA remained associated with balance (all p < .05).
Both self-reported and performance-based VI are strongly associated with poor lower extremity physical function. These findings may identify a subgroup of older adults with co-existing visual and physical dysfunction who may benefit from targeted screening and intervention to prevent disability.
评估自我报告和基于表现的视力障碍（VI）与下肢身体功能之间的关系。
横断面分析了 2219 名完成视力测试和短体物理性能测试（SPPB）的健康 ABC 参与者。线性回归模型分别使用自我报告（加权视觉功能问卷[VFQ]评分）或基于表现的（视力[VA]、对数对比敏感度[LCS]、Frisby 立体视锐度[SA]）来预测 SPPB 或其组成部分-步态速度、椅子站立或站立平衡-有无协变量调整。
平均年龄为 73.5 岁（范围 69-80）；52.4%为女性，37.4%为非裔美国人。所有 VI 测量指标在未调整和调整后的模型中均与 SPPB 呈强烈相关（p<0.001）。自我报告的 VFQ 评分比平均值低 1 个标准差（平均值为 100 分中的 87.8 分），则 SPPB 调整后的差异为-0.241（95%置信区间[CI]：-0.325，-0.156）。在控制协变量后，VA<20/40（41%）的 SPPB 评分降低了-0.496（-0.660，-0.331），而 SA 评分>85 弧秒（30%）的 SPPB 评分降低了-0.449（-0.627，-0.271）与视觉功能更好的人相比。LCS<1.55（28.6%）与 SPPB 评分降低-0.759（-0.938，-0.579）相关，而 LCS≤1.30（8%）与 SPPB 评分降低-1.216（-1.515，-0.918）相关与更好的 LCS 相比。在包含多种视力测量的最终多变量模型中，LCS 与 SPPB 和所有成分均保持独立相关，而 SA 与平衡保持相关（均 p<0.05）。
自我报告和基于表现的 VI 均与下肢身体功能不良密切相关。这些发现可能会确定一组存在视力和身体功能障碍的老年患者亚组，他们可能受益于有针对性的筛查和干预措施，以预防残疾。
