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Declines in vision, activity linked to increased mortality risk
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Researchers discovered a direct relationship between loss of visual acuity and decline in instrumental activities of daily living levels, which increases the risk of mortality in older adults.
The prospective longitudinal study included 2,520 noninstitutionalized adults between 65 and 84 years old. Patients were reassessed at 2, 6 and 8 years after baseline. The study involved an at-home interview and a 4- to 5-hour clinic examination.
Patients were self-assessed on activities of daily living (ADL) items such as: getting out of bed or a chair, dressing oneself, bathing or showering.
According to the study, instrumental activities of daily living (IADL) assessment included: using the telephone, doing light housework, managing money and shopping for personal items.
In the researchers’ final model, according to the study, visual acuity (VA) levels at baseline and VA change over time did not directly predict mortality.
However, the researchers wrote, baseline ADL levels and changes in IADL were significant predictors of mortality even after controlling for all covariates and VA and ADL baseline levels and changes over time.
A 1-unit increase in baseline IADL score was associated with an increased risk for death (hazard ratio: 1.36). Furthermore, for a mean increase of 1 unit in the annual rate of IADL score, the hazard of death was nearly 3.5 times that of individuals with stable IADL levels over time, according to the study.
“In other words,” the researchers wrote, “individuals who experienced increasing difficulty with IADL by the mean amount (0.0027 per year) had an increase in mortality hazard that was 3% greater annually and 31% greater during the 8-year study period than individuals with a stable IADL difficulty level.”
The authors said their findings reinforce the need for primary prevention of visual impairment, which is often correctable with glasses or contact lenses. They also noted that it is important to help patients maintain their activity level when their visual impairment is uncorrectable.
Disclosure: The researchers reported no conflicts of interest.
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