Association of Visual Impairment with Mobility and Physical Function

OBJECTIVE: To examine the association of distant vision and physical function in the population of older adults. DESIGN: Cross-sectional and cohort study. PARTICIPANTS: 5143 older residents of three communities (Established Populations for the Epidemiologic Studies of the Elderly) who were interviewed in 1988-89, including residents of two communities who were re-interviewed 15 months later (n = 3133, 97% of those eligible). MEASURES: Visual acuity screening, self-reported activities of daily living and mobility, and objective physical performance measures of balance, walking, and rising from a chair. RESULTS: Limitations in mobility, activities of daily living, and physical performance were associated with worse visual function. In prospective analyses controlling for potential confounders, participants with severe visual impairment had 3-fold higher odds of incident mobility and activity of daily living limitations than those with acuity of 20/40 or better (P < 0.001). In prospective analyses investigating the relationship of vision with improvement in function, those with poor vision were about half as likely to improve as those with better acuity, but this relationship was only statistically significant for improvement in mobility limitations. CONCLUSIONS: Distant visual function appears to play an important role in physical function, particularly for mobility. An intervention to improve vision in at-risk elders might preserve function and prevent disability; this warrants further investigation.