Near Vision Impairment and Frailty: Evidence of an Association

Purpose To examine associations between near vision impairment (NVI) and frailty. Design Cross-sectional study. Methods Setting : Nationally representative sample of noninstitutionalized United States civilians. Study Population : Total of 2705 older adults aged ≥60 years from National Health and Nutrition Examination Survey (1999-2002). Observation : Presenting NVI (PNVI): near acuity worse than 20/40. Self-reported NVI (SNVI): self-reported difficulty with near vision tasks. Main Outcome Measure(s) : Five-item physical frailty index; participants classified as frail (≥3 criteria) and prefrail (1 or 2 criteria). Propensity score–adjusted and probability-weighted multinomial multivariable logistic regression was used to examine associations of PNVI and SNVI with frailty. Results Of 2705 participants, 381 (10%), 160 (5%), and 106 (3%) had PNVI only, SNVI only, and PNVI+SNVI, respectively. In fully adjusted models, as compared to those without PNVI, participants with PNVI were more likely to be prefrail (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.1, 2.3) and frail (OR = 2.5; 95% CI = 1.4, 4.3). As compared to those without SNVI, participants with SNVI were more likely to be prefrail (OR = 2.9; 95% CI = 1.8, 4.7) and frail (OR = 4.3; 95% CI = 2.2, 8.3). As compared to those without PNVI or SNVI, participants with PNVI+SNVI were more likely to be prefrail and frail (prefrail: OR = 4.0; 95% CI = 2.2, 7.2 and frail: OR = 4.5; 95% CI = 1.7,12.7). Conclusions Older adults with PNVI and SNVI were more likely to be prefrail and frail than those without respective NVI, suggesting that NVI is associated with frailty.