Is the visual impairment a risk factor for frailty in older adults? A systematic review and meta-analysis of 10-year clinical studies.

Abstract

Frailty is linked to poor health outcomes later in life. Recent research suggests that visual loss is a possible modifiable risk factor for frailty. To analyze the relationship between visual impairment (VI) and frailty and investigate whether it can increase the risk of frailty in older adults. We performed a systematic review and meta-analysis of cohort studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched PubMed, Embase, and Scopus databases for relevant studies published between 2012 and 2022 that clearly described VI and frailty measurement methods. Cross-sectional and longitudinal studies that examined the associations between VI and the existence of frailty in adults aged 65years or older were synthesized. Meta-analyses were conducted using the measurement of risk and a 95% confidence interval for each study. Quality assessment using the Newcastle-Ottawa Scale (NOS), risk of bias, heterogeneity, and sensitivity analyses were also conducted. Our search identified 1074 manuscripts published in the English language between 1 January 2012 and 9 June 2022. After studies screening, seventeen articles, including 22,192 participants and 3624 cases of frailty, were selected. A random-effect meta-analysis demonstrated a significant association between visual impairment and the risk of frailty (OR 2.13; 95% CI 1.67-2.72). The quality rating of the cross-sectional studies averaged 8.33 (95% CI 7.77-8.89) of the maximum score on the NOS. Visual impairment increases the risk of frailty in later life and should be accurately assessed in frail older adults.