Associations of vision impairment and eye diseases with frailty in community-dwelling older adults: a nationwide longitudinal study in China

Aims To test whether vision impairment and major ophthalmic conditions are predictive of frailty. Methods The analysis included 5321 participants aged 60–95 years at baseline from the China Health and Retirement Longitudinal Study. Participants were enrolled in 2011 and followed up in 2013, and 2015 through a face-to-face interview. Distance/near vision impairment was defined by reporting poor eyesight and reporting excellent, very good, good or fair eyesight was used as the reference. A history of cataract surgery and glaucoma were also self-reported. Frailty was defined as the presence of ≥3 of the five components of the Fried phenotype: weakness, slowness, exhaustion, inactivity and shrinking. Results In the cross-sectional analysis, both near (odds ratio [OR] (95% confidence interval [CI]): 1.62 (1.30 to 2.00)) and distance (1.59 (1.30 to 1.96)) vision impairment was associated with a higher prevalence of frailty independent of confounders. In the longitudinal analysis, the multivariable-adjusted OR (95% CI) for incident frailty associated with glaucoma, distance vision impairment, near vision impairment and vision problem was 3.41 (1.46 to 7.99), 1.59 (1.17 to 2.17), 1.62 (1.17 to 2.23) and 2.11 (1.41 to 3.15), respectively. Vision problem was associated with decreased handgrip strength (β (95% CI): −1.47 (−2.20 to –0.75) kg) during follow-up. Individuals with glaucoma (−0.11 (−0.16 to –0.05) m/s), distance vision impairment (−0.02 (−0.03 to 0.00) m/s) or vision problem (−0.02 (−0.05 to 0.00) m/s) had decreased gait speed compared with the control group. Conclusions Vision problem, vision impairment and glaucoma are important predictors of frailty in older adults.