Abstract
PurposeManaging stairs is a challenging aspect of daily activities of living for older people. We assessed whether older adults with visual impairment (VI) have greater difficulties of managing stairs in daily lives.MethodsThe study was designed as a community-based cross-sectional study based on a Chinese cohort aged 60 years and older in rural China. Visual acuity (VA) was measured in both eyes using a retro-illuminated Snellen chart with tumbling-E optotypes. VI (including blindness) was defined as presenting VA of worse than 20/60 in either eye. Having any difficulties in managing stairs was self-reported based on a question drawn from the Barthel Index. Information on participants’ socioeconomic status, lifestyle-related factors, diseases histories and medication intake was collected using a questionnaire.ResultsThe Barthel Index, Activities of Daily Living questionnaire was completed by 4597 (99.7%) participants including 2218 men and 2379 women. The age of the participants ranged from 60 to 93 years with a mean of 67.6 ± 6.3 years. In age and gender adjusted models, adults with VI had a higher likelihood of having difficulties in managing stairs (odds ratio [OR] = 2.7; 95% confidence interval [CI] 2.0, 3.7) compared with those without. The association of VI with the likelihood of having difficulties in managing stairs was stronger in older adults who lived alone (OR = 3.2; 95%CI 1.8, 4.5) compared with those who lived with other family members (OR = 2.0; 95%CI 1.3, 4.3). Compared with hypertension, diabetes, obesity and cognitive dysfunction, VI had the greatest impact on people's abilities of managing stairs.ConclusionVI was associated with an increased likelihood of having difficulties in managing stairs, especially in those who lived alone. However, whether the finding could be extrapolated to other populations warrants further studies as different environmental exposures such as illumination and types of stairs may alter the association observed in this study.
Highlights
Visual impairment (VI) is one of the most devastating disabilities throughout the world
In age and gender adjusted models, adults with VI had a higher likelihood of having difficulties in managing stairs compared with those without
The association of VI with the likelihood of having difficulties in managing stairs was stronger in older adults who lived alone (OR = 3.2; 95%confidence interval (CI) 1.8, 4.5) compared with those who lived with other family members (OR = 2.0; 95%CI 1.3, 4.3)
Summary
Visual impairment (VI) is one of the most devastating disabilities throughout the world. It was estimated that 285 million people are visually impaired worldwide.[1] The absolute number of visually impaired people is still increasing, which is driven by population aging, longer life expectancy and increasing burden of chronic systemic diseases such as diabetes and hypertension.[2] nowadays vision screening outreach and eye care programs have become increasingly widespread in both developed and developing countries, quite a few people with VI remain undiagnosed and untreated.[3] VI is intimately associated with functional limitations[4], falls[5], depressive symptoms[6], cognitive dysfunction[7], worse health-related quality of life[8] and increased risk of mortality[9, 10]. Visual impairment and its consequence are responsible for consuming a huge share of healthcare costs and impose heavy socioeconomic burden on the individuals, communities and countries. It was reported that VI costs the world an estimated 2.3 trillion dollars annually.[3] In mainland of China, the prevalence of VI varies significantly by geographic regions. The prevalence of VI was estimated to be 3.6% in East China, 3.6% in Central China and 5.2% in Western China while the prevalence of blindness was 1.4% in East China, and 1.4% in Central China and 2.5% in Western China.[11]
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