Association of Visual Disorders with Severe Loss of Functionality in Older Patients with Frailty

The Russian Federation is experiencing a continuous trend of rapid aging within society, with the older population projected to make up 28% by 2030. To reduce economic and social losses, a geriatric service has been introduced in the Russian Federation, focusing on maintaining the functionality of an older people. The functionality of older patients is evaluated using the Barthel Index based on comprehensive geriatric assessment. One of the most common geriatric syndromes is visual impairment. However, there is still no consensus on the role of vision pathology in the development of frailty.

OBJECTIVE. To assess the relationship between the function of the visual organ and the preservation of functionality according to the Barthel scale among older people.

MATERIALS AND METHODS. The article investigates the ophthalmic status of older people (n = 481) aged 75 and older, who were hospitalized for frailty in a geriatric hospital. The study assessed visual acuity using the Sivtsev — Golovin table and confirmed ophthalmological diagnoses. Older participants were categorized based on their level of functionality: severe loss (Barthel index less than 60) and preserved functionality (Barthel index 60 and above). Statistical analysis was conducted using logistic regression to determine the presence of any relationships

RESULTS. The study examined the relationship between patients' sex and age with visual acuity, leading ophthalmological diagnoses, and their connection to functionality (according to the Barthel index). The results showed significant associations between impaired functionality and cataracts (OR = 1.95, 95% CI 1.21–3.12), AMD (OR = 2.64, 95% CI 1.50–4.64), and refractive error (OR = 1.95, 95% CI 1.10–3.49).

CONCLUSION. The presence of multiple eye pathologies increased the likelihood of functionality loss in older patients. The study highlights the importance of implementing organizational solutions for managing older patients with vision problems and suggests a new approach for ophthalmologists to preserve functionality in older patients.

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