Visual impairment at baseline is associated with future poor physical functioning among middle-aged women: The Study of Women’s Health Across the Nation, Michigan Site

Abstract

Objectives Emerging evidence suggests that the prevalence rates of poor functioning and of disability are increasing among middle-aged individuals. Visual impairment is associated with poor functioning among older adults but little is known about the impact of vision on functioning during midlife. The objective of this study was to assess the impact of visual impairment on future physical functioning among middle-aged women. Study design In this longitudinal study, the sample consisted of 483 women aged 42 to 56 years, from the Michigan site of the Study of Women's Health Across the Nation. Main Outcome Measures At baseline, distance and near vision were measured using a Titmus vision screener. Visual impairment was defined as visual acuity worse than 20/40. Physical functioning was measured up to 10 years later using performance-based measures, including a 40-foot timed walk, timed stair climb and forward reach. Results Women with impaired distance vision at baseline had 2.81 centimeters less forward reach distance (95% confidence interval (CI): −4.19,−1.42) and 4.26 seconds longer stair climb time (95% CI: 2.73, 5.79) at follow-up than women without impaired distance vision. Women with impaired near vision also had less forward reach distance (2.26 centimeters, 95% CI: −3.30,−1.21) than those without impaired near vision. Conclusion Among middle-aged women, visual impairment is a marker of poor physical functioning. Routine eye testing and vision correction may help improve physical functioning among midlife individuals.

Self-rated eyesight and handgrip strength in older adults

“…The present findings are in line with previous studies that have shown that older people with visual impairment have worse levels of physical functioning than those with normal vision, using less practical measures of functioning (e.g. an obstacle course or a battery of fitness tests) and smaller samples [3,[14][15][16]. The present study adds to this literature by showing that people with visual impairment have slightly worse levels of handgrip strength which can consequently be associated with lower physical functioning.…”

“…Few studies have explicitly tested the association between visual impairment and physical performance in older age, but those that have indicate decrements among those with poor vision. One study of middleaged women (n=483, age 42-56 years) observed poorer performance on a battery of tests (including a 40-foot timed walk, timed stair climb and forward reach) in women with impaired vision over 10-year follow-up [14]. Similarly, a study of 6,112 women aged 69 and older reported an association between visual impairment and functional decline [3].…”

Visual Function, Physical Function, and Activities of Daily Living in Two Aging Communities

“…Previous evidence has identified VI as a marker of poor physical functioning over 10 years. 49 However, adults who were physically active have been found to have a lower cumulative incidence of VI, which could suggest behavioral impacts on vision outcomes. 50 Longitudinal and interventional studies are needed to further understand the direction of such associations and whether the prevention of physical limitations can be accomplished through vision correction.…”

Validity of the Titmus Vision Screener: A Comparison with the Snellen Chart

“…Vision impairment (VI) affects 191 million people globally, mostly due to treatable or preventable causes [1]. VI is associated with a wide range of adverse outcomes including poor quality of life, worse functioning and detrimental impact on mental health [2,3,4,5,6]. Vision screening is an important public health measure to address the burden of VI.…”

“…Space and lighting requirements for testing vision are factors limiting the use of conventional vision testing methods in non-eye care settings. The Titmus vision screener is an instrument that is widely used in these situations, given its portability and ease of use [6,7]. It is a vision screening device with optically simulated distance and near vision settings and has built -in lighting for vision testing.…”