1
|
Thompson AC, Miller ME, Webb CC, Williamson JD, Kritchevsky SB. Relationship of Self-reported and Performance-based Visual Function With Performance-based Measures of Physical Function: The Health ABC Study. J Gerontol A Biol Sci Med Sci 2023; 78:2060-2069. [PMID: 36346340 PMCID: PMC10613017 DOI: 10.1093/gerona/glac225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND To assess the relationship between self-reported and performance-based visual impairment (VI) and lower extremity physical function. METHODS 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. RESULTS 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). CONCLUSIONS 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.
Collapse
Affiliation(s)
- Atalie C Thompson
- 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
| | - Michael E Miller
- Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
| | - Christopher C Webb
- Department of Surgical Ophthalmology, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
| | - Jeff D Williamson
- 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
| | - Stephen B Kritchevsky
- Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
| |
Collapse
|
2
|
Li M, Li C, Huang Q, Zhou H, Xie L, Chen F, Lin S, Yang J. Refining and psychometric evaluation of the falling risk assessment tool in ophthalmology inpatients. Nurs Open 2023; 10:6912-6922. [PMID: 37458186 PMCID: PMC10495720 DOI: 10.1002/nop2.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 06/07/2023] [Accepted: 07/07/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS The aim of this study was to refine the Falling Risk Assessment Tool in Ophthalmology Inpatients (FRAT) and assess its psychometric properties. DESIGN A cross-sectional design was used. METHODS A convenience sample of 730 patients in the ophthalmology department was recruited in a level A tertiary hospital in Guangdong Province from July 2021 to January 2022. Data were analysed using item analysis, interrater reliability, content validation, internal consistency reliability and exploratory factor analysis. RESULTS Five factors were extracted, accounting for 63.039% of the variance. The interrater reliability of the tool was 0.97. Cronbach's α was 0.658. The I-CVI was 0.75-1.00, the S-CVI/UA was 0.95 and the adjusted mean values of Kappa for indicators ranged from 0.72 to 1.00, as evaluated by the expert group. The FRAT showed satisfactory reliability and validity, and can be used to measure the fall risk assessment in ophthalmology inpatients. PATIENT OR PUBLIC CONTRIBUTION After explaining the purpose, the patients received our fall risk assessment and answered the corresponding questionnaire questions.
Collapse
Affiliation(s)
- Muling Li
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Chunmei Li
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Qinghui Huang
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Hongzhen Zhou
- Department of NursingNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Ling Xie
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Fangni Chen
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Shaoqin Lin
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Juan Yang
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| |
Collapse
|
3
|
Hall CD, Barnes CS, Gutherie AH, Lynch MG. Visual function and mobility after multifocal versus monofocal intraocular lens implantation. Clin Exp Optom 2021; 105:70-76. [PMID: 33730524 DOI: 10.1080/08164622.2021.1896337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Clinical relevance: Mobility and fall risk may be important considerations in choosing between intraocular lenses.Background: Fall risk in older adults increases when wearing multifocal spectacles, but little is known about mobility among individuals with different types of intraocular lenses. This study compared visual function, fall risk and balance control following bilateral implantation of monofocal or multifocal intraocular lenses.Methods: This was a non-randomised, cross-sectional study involving adults with bilateral intraocular lenses. Participants completed questionnaires concerning physical functioning, fall history and balance-related confidence. Binocular visual acuity, contrast sensitivity (Pelli-Robson chart and computerized testing), depth perception and glare sensitivity were assessed. Physical performance measures included the Sensory Organization Test, preferred gait speed, Dynamic Gait Index and wayfinding in a virtual environment.Results: Fifteen participants (mean ± standard deviation, 67.1 ± 6.8 years) had monofocal intraocular lenses and 14 participants (68.1 ± 6.1 years) had multifocal intraocular lenses. Contrast sensitivity in the monofocal group was significantly better than that in the multifocal group (p = 0.02) at intermediate and high spatial frequencies. Contrast sensitivity of the monofocal group also was less affected by glare than the contrast sensitivity of the multifocal group, at an intermediate spatial frequency (p = 0.02). However, the multifocal group had significantly better Dynamic Gait Index scores (p = 0.04), even after controlling for perceived physical function.Conclusions: The participants with monofocal intraocular lenses generally had better contrast sensitivity than did those with multifocal intraocular lenses. However, the scores on a mobility test that is associated with fall risk were worse for those with monofocal lenses.
Collapse
Affiliation(s)
- Courtney D Hall
- Hearing and Balance Research Program, James H. Quillen VA Medical Center, Mountain Home, TN, USA.,Physical Therapy Program, College of Clinical and Rehabilitative Health Sciences, East Tennessee State University, Johnson City, TN, USA
| | | | - Audrey H Gutherie
- Rehabilitation Research & Development Center, Atlanta VA Medical Center, Decatur, GA, USA
| | - Mary G Lynch
- The Eye Clinic, Atlanta VA Medical Center, Decatur, GA, USA
| |
Collapse
|
4
|
Ong T, Khor HM, Kumar CS, Singh S, Chong E, Ganthel K, Lee JK. The Current and Future Challenges of Hip Fracture Management in Malaysia. Malays Orthop J 2020; 14:16-21. [PMID: 33403058 PMCID: PMC7751988 DOI: 10.5704/moj.2011.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/01/2020] [Indexed: 12/27/2022] Open
Abstract
By 2050, it is predicted that six million hip fractures will occur each year of which the majority will happen in Asia. Malaysia is not spared from this predicted rise and its rate of increase will be one of the highest in this region. Much of this is driven by our unprecedented growth in the number of older people. Characteristics of individuals with hip fractures in Malaysia mirror what has been reported in other countries. They will be older multimorbid people who were already at risk of falls and fractures. Outcomes were poor with at least a quarter do not survive beyond 12 months and in those that do survive have limitation in their mobility and activities of daily living. Reviewing how these fractures are managed and incorporating new models of care, such as orthogeriatric care, could address these poor outcomes. Experts have warned of the devastating impact of hip fracture in Malaysia and that prompt action is urgently required. Despite that, there remains no national agenda to highlight the need to improve musculoskeletal health in the country.
Collapse
Affiliation(s)
- T Ong
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - H M Khor
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - C S Kumar
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - S Singh
- Department of Orthopaedic Surgery, University of Malaya, Kuala Lumpur, Malaysia
| | - Egm Chong
- Department of Geriatric Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - K Ganthel
- Department of Orthopaedics, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - J K Lee
- Department of Orthopaedics, Beacon Hospital, Petaling Jaya, Malaysia
| |
Collapse
|
5
|
Paz LPDS, Borges LDL, Marães VRFDS, Gomes MMF, Bachion MM, Menezes RLD. Factors associated with falls in older adults with cataracts. CIENCIA & SAUDE COLETIVA 2018; 23:2503-2514. [PMID: 30137120 DOI: 10.1590/1413-81232018238.14622016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 09/02/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to evaluate factors associated with falls in community-dwelling older adults diagnosed with cataracts. An analytical, cross-sectional study was conducted with a sample of community-dwelling older adults residing in the Federal District of Brazil. Interviews and assessment tools were administered, such as the Timed Up and Go test, Short Physical Performance Battery (SPPB), Biodex Balance System, Katz Index, Lawton Scale, Minnesota Leisure Time Physical Activity Questionnaire and Mini Mental State Examination. Statistical analysis involved binary logistic regression. One hundred forty-two older adults (85 with cataracts) participated in the study (mean age: 69.39 ± 5.67 years). Falls were associated with the female sex (OR: 4.45) and sub-maximum score on the SPPB (OR: 3.53) among patients with cataracts, whereas multimorbidity (OR: 5.10) was the risk factor risk for older adults without cataracts. The data suggest different risk factors for falls among older adults diagnosed with cataracts.
Collapse
Affiliation(s)
- Leonardo Petrus da Silva Paz
- Faculdade de Ceilândia, Universidade de Brasília (UnB). Universidade de Brasília,. QNN14 AE CEI-Sul, Guariroba. 72220-140 Brasília DF Brasil.
| | | | | | | | | | | |
Collapse
|
6
|
Assessment of physical inactivity and locomotor dysfunction in adults with visual impairment. Sci Rep 2018; 8:12032. [PMID: 30104680 PMCID: PMC6089939 DOI: 10.1038/s41598-018-30599-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 07/20/2018] [Indexed: 12/29/2022] Open
Abstract
To evaluate the association between vision-related quality of life (QoL), physical inactivity, and locomotor dysfunction in subjects with visual impairment.This cross-sectional study included 215 visually impaired subjects recruited from six ophthalmology departments in Japan. The physical inactivity and locomotor dysfunction associated with their visual impairment was investigated. The physical activity level was assessed using the short form of the International Physical Activity Questionnaire and classified as high, moderate, or low. Locomotor function was evaluated with the Geriatric Locomotive Function Scale. Vision-related QoL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire. Background data, including for age, sex, best-corrected visual acuity for each eye, causative eye diseases, systemic comorbidities, and body mass index, were also collected.The average patient age was 69.6 (range, 20-93 years; standard deviation, 14.5 years) and 118 patients (54.9%) were men. Multivariate analysis showed that vision-related QoL and best-corrected visual acuity in the worse eye were significantly associated with physical inactivity and that vision-related QoL, female sex, age, and presence of systemic comorbidity were significantly associated with locomotor dysfunction. Vision-related quality of life is associated with physical inactivity and locomotor dysfunction.
Collapse
|
7
|
Devkota S, Anderson B, Soiza RL, Myint PK. Prevalence and determinants of frailty and associated comorbidities among older Gurkha welfare pensioners in Nepal. Geriatr Gerontol Int 2017; 17:2493-2499. [DOI: 10.1111/ggi.13113] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 04/13/2017] [Accepted: 05/09/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Sirjana Devkota
- Ageing Clinical and Experimental Research (ACER) Team; Institute of Applied Health Sciences, University of Aberdeen; UK
| | | | - Roy L. Soiza
- Health Services Research Unit; Institute of Applied Health Sciences, University of Aberdeen; UK
- Academic Department of Medicine for the Elderly, NHS Grampian; Aberdeen UK
| | - Phyo K. Myint
- Ageing Clinical and Experimental Research (ACER) Team; Institute of Applied Health Sciences, University of Aberdeen; UK
- Academic Department of Medicine for the Elderly, NHS Grampian; Aberdeen UK
| |
Collapse
|
8
|
Romli MH, Tan MP, Mackenzie L, Lovarini M, Suttanon P, Clemson L. Falls amongst older people in Southeast Asia: a scoping review. Public Health 2017; 145:96-112. [PMID: 28359399 DOI: 10.1016/j.puhe.2016.12.035] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/07/2016] [Accepted: 12/20/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The older population in the Southeast Asian region is accelerating and is expected to surpass the proportion of the ageing population in North America and Europe in the future. This study aims to identify the research literature related to falls among older people in Southeast Asia, to examine current practice and discuss the future direction on falls prevention and interventions in the region. STUDY DESIGN A scoping review design was used. METHODS A systematic literature search was conducted using the Medline, CINAHL, AMED, Ageline, PsycINFO, Web of Sciences, Scopus, Thai-Journal Citation Index, MyCite and trial registries databases. RESULTS Thirty-seven studies and six study protocols were included, from Thailand, Malaysia, Singapore, Vietnam, Indonesia and the Philippines. One-sixth of the studies involved interventions, while the remainder were observational studies. The observational studies mainly determined the falls risk factors. The intervention studies comprised multifactorial interventions and single interventions such as exercises, educational materials and visual correction. Many of the studies replicated international studies and may not have taken into account features unique to Southeast Asia. CONCLUSION Our review has revealed studies evaluating falls and management of falls in the Southeast Asian context. More research is required from all Southeast Asian countries to prepare for the future challenges of managing falls as the population ages.
Collapse
Affiliation(s)
- M H Romli
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia; Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - M P Tan
- Ageing and Age Associated Disorders Research Group, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - L Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
| | - M Lovarini
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
| | - P Suttanon
- Faculty of Allied Health Sciences, Thammasat University, 99 Moo 18 Paholyothin Road, Klong Luang, Rangsit, Prathumthani 12120, Thailand.
| | - L Clemson
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
| |
Collapse
|
9
|
To KG, Meuleners L, Bulsara M, Fraser ML, Duong DV, Do DV, Huynh VAN, Phi TD, Tran HH, Nguyen ND. A longitudinal cohort study of the impact of first- and both-eye cataract surgery on falls and other injuries in Vietnam. Clin Interv Aging 2014; 9:743-51. [PMID: 24812501 PMCID: PMC4011894 DOI: 10.2147/cia.s61224] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim Little information exists on the impact of cataract surgery on falls and other injuries in Vietnam. The aim of this study was to determine the impact of first and both eye cataract surgery on the number of falls and other injuries among bilateral cataract patients in Ho Chi Minh City, Vietnam. Materials and methods A longitudinal cohort study was conducted involving 413 bilateral cataract patients aged 50+ years. Participants were assessed at three time points: 1 week before, 1–3 months after, and 1 year after first-eye cataract surgery. Visual measures (visual acuity, contrast sensitivity and stereopsis) were taken, and self-reported falls and injury data were collected. A multilevel longitudinal Poisson regression model was used to investigate change in the number of falls after surgery. Results The risk of falls decreased by 78% (incidence-rate ratio [IRR] 0.22, 95% confidence interval [CI] 0.06–0.77; P=0.018) in the year after cataract surgery for participants who had first-eye surgery only and 83% (IRR 0.17, 95% CI 0.04–0.69; P=0.012) for participants who had the second eye operated on compared to before surgery. The risk of falls was three times higher for females than males (IRR 3.13, 95% CI 1.53–6.40; P=0.002). Improved binocular contrast sensitivity was also associated with a decrease in falls (IRR 0.40, 95% CI 0.17–0.97; P=0.042). The prevalence of other injuries also decreased after cataract surgery. Conclusion Cataract surgery reduced the number of falls and other injuries in Vietnam. Contrast sensitivity may be important for ophthalmologists to consider when prioritizing patients for surgery and assessing their fall risk.
Collapse
Affiliation(s)
- Kien Gia To
- Curtin Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, WA, Australia ; University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Lynn Meuleners
- Curtin Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia
| | - Michelle L Fraser
- Curtin Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | | | - Dung Van Do
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | | | | | | |
Collapse
|
10
|
To KG, Meuleners LB, Fraser ML, Do DV, Duong DV, Huynh VAN, To QG, Phi TD, Tran HH, Nguyen ND. Prevalence and visual risk factors for falls in bilateral cataract patients in Ho Chi Minh City, Vietnam. Ophthalmic Epidemiol 2014; 21:79-85. [PMID: 24568591 DOI: 10.3109/09286586.2014.885058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine the prevalence of falls in the 12 months prior to cataract surgery and examine the associations between visual and other risk factors and falls among older bilateral cataract patients in Vietnam. METHODS Data collected from 413 patients in the week before scheduled cataract surgery included a questionnaire and three objective visual tests. RESULTS The outcome of interest was self-reported falls in the previous 12 months. A total of 13% (n = 53) of bilateral cataract patients reported 60 falls within the previous 12 months. After adjusting for age, sex, race, employment status, comorbidities, medication usage, refractive management, living status and the three objective visual tests in the worse eye, women (odds ratio, OR, 4.64, 95% confidence interval, CI, 1.85-11.66), and those who lived alone (OR 4.51, 95% CI 1.44-14.14) were at increased risk of a fall. Those who reported a comorbidity were at decreased risk of a fall (OR 0.43, 95% CI 0.19-0.95). Contrast sensitivity (OR 0.31, 95% CI 0.10-0.95) was the only significant visual test associated with a fall. These results were similar for the better eye, except the presence of a comorbidity was not significant (OR 0.45, 95% CI 0.20-1.02). Again, contrast sensitivity was the only significant visual factor associated with a fall (OR 0.15, 95% CI 0.04-0.53). CONCLUSION Bilateral cataract patients in Vietnam are potentially at high risk of falls and in need of falls prevention interventions. It may also be important for ophthalmologists and health professionals to consider contrast sensitivity measures when prioritizing cataract patients for surgery and assessing their risk of falls.
Collapse
Affiliation(s)
- Kien Gia To
- University of Medicine and Pharmacy , Ho Chi Minh City , Vietnam
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Skalska A, Wizner B, Piotrowicz K, Klich-Rączka A, Klimek E, Mossakowska M, Rowiński R, Kozak-Szkopek E, Jóźwiak A, Gąsowski J, Grodzicki T. The prevalence of falls and their relation to visual and hearing impairments among a nation-wide cohort of older Poles. Exp Gerontol 2013; 48:140-6. [DOI: 10.1016/j.exger.2012.12.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 11/09/2012] [Accepted: 12/06/2012] [Indexed: 10/27/2022]
|
12
|
Richer S, Cho J, Stiles W, Levin M, Wrobel JS, Sinai M, Thomas C. Retinal spectral domain optical coherence tomography in early atrophic age-related macular degeneration (AMD) and a new metric for objective evaluation of the efficacy of ocular nutrition. Nutrients 2012; 4:1812-27. [PMID: 23363992 PMCID: PMC3546609 DOI: 10.3390/nu4121812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 11/12/2012] [Accepted: 11/14/2012] [Indexed: 01/30/2023] Open
Abstract
Purpose: A challenge in ocular preventive medicine is identification of patients with early pathological retinal damage that might benefit from nutritional intervention. The purpose of this study is to evaluate retinal thinning (RT) in early atrophic age-related macular degeneration (AMD) against visual function data from the Zeaxanthin and Visual Function (ZVF) randomized double masked placebo controlled clinical trial (FDA IND #78973). Methods: Retrospective, observational case series of medical center veterans with minimal visible AMD retinopathy (AREDS Report #18 simplified grading 1.4/4.0 bilateral retinopathy). Foveal and extra-foveal four quadrant SDOCT RT measurements were evaluated in n = 54 clinical and ZVF AMD patients. RT by age was determined and compared to the OptoVue SD OCT normative database. RT by quadrant in a subset of n = 29 ZVF patients was correlated with contrast sensitivity and parafoveal blue cone increment thresholds. Results: Foveal RT in AMD patients and non-AMD patients was preserved with age. Extrafoveal regions, however, showed significant slope differences between AMD patients and non-AMD patients, with the superior and nasal quadrants most vulnerable to retinal thinning (sup quad: −5.5 μm/decade thinning vs. Non-AMD: −1.1 μm/decade, P < 0.02; nasal quad: −5.0 μm/decade thinning vs. Non-AMD: −1.0 μm/decade, P < 0.04). Two measures of extrafoveal visual deterioration were correlated: A significant inverse correlation between % RT and contrast sensitivity (r = −0.33, P = 0.01, 2 Tailed Paired T) and an elevated extrafoveal increment blue cone threshold (r = +0.34, P = 0.01, 2 Tailed T). Additional SD OCT RT data for the non-AMD oldest age group (ages 82–91) is needed to fully substantiate the model. Conclusion: A simple new SD OCT clinical metric called “% extra-foveal RT” correlates well with functional visual loss in early AMD patients having minimal visible retinopathy. This metric can be used to follow the effect of repleting ocular nutrients, such as zinc, antioxidants, carotenoids, n-3 essential fats , resveratrol and vitamin D.
Collapse
Affiliation(s)
- Stuart Richer
- Eye Clinic, James A Lovell Federal Health Care Center, North Chicago, IL 60064, USA; (J.C.); (W.S.); (M.L.); (C.T.)
- Family & Preventive Medicine, RFUMS Chicago Medical School, North Chicago, IL 60064, USA
- Author to whom correspondence should be addressed; ; Tel.: +1-224-610-7145
| | - Jane Cho
- Eye Clinic, James A Lovell Federal Health Care Center, North Chicago, IL 60064, USA; (J.C.); (W.S.); (M.L.); (C.T.)
- Family & Preventive Medicine, RFUMS Chicago Medical School, North Chicago, IL 60064, USA
| | - William Stiles
- Eye Clinic, James A Lovell Federal Health Care Center, North Chicago, IL 60064, USA; (J.C.); (W.S.); (M.L.); (C.T.)
| | - Marc Levin
- Eye Clinic, James A Lovell Federal Health Care Center, North Chicago, IL 60064, USA; (J.C.); (W.S.); (M.L.); (C.T.)
| | - James S. Wrobel
- Internal Medicine, Podiatry Services, University of Michigan, Ann Arbor, MI 48105, USA;
| | | | - Carla Thomas
- Eye Clinic, James A Lovell Federal Health Care Center, North Chicago, IL 60064, USA; (J.C.); (W.S.); (M.L.); (C.T.)
| |
Collapse
|
13
|
Uemura K, Yamada M, Nagai K, Mori S, Ichihashi N. Reaction time for peripheral visual field increases during stepping task in older adults. Aging Clin Exp Res 2012; 24:365-9. [PMID: 23238311 DOI: 10.1007/bf03325267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS For safe locomotion, visual attention must be directed toward not only the central visual field but also the peripheral visual field. This study explored the effect of stepping task on reaction time for the central and peripheral visual fields in young and older adults. METHODS Nine older (mean age 83.8±6.8 years) and 11 young adults (mean age 22.9±1.3 years) participated in this study. Reaction times to press a handheld button in response to stimuli for the central and peripheral visual fields were measured in static standing and stepping task conditions. RESULTS Vision angle and condition were significantly associated with reaction time in the older group (p=0.006), while reaction time in the young group was affected by vision angle only. Reaction times for visual stimulus at a 45° vision angle were significantly longer in the older group in stepping task conditions than in static standing conditions. CONCLUSIONS Effective visual field may diminish during lightly loaded exercise in older adults.
Collapse
Affiliation(s)
- Kazuki Uemura
- Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Daikouminami, Higashi-ku, Nagoya, Japan.
| | | | | | | | | |
Collapse
|