Associations between eye disorders and physical impairment features in elderly and senescent patients

BACKGROUND. Impaired balance, gait speed, and movement speed are among the leading geriatric syndromes affecting the quality of life in older adults. Sensory deficits in elderly patients include visual and hearing impairments. Sensory and physical impairments are considered potentially modifiable factors that may improve prognosis and influence other health domains in aging individuals.

However, the interplay between these geriatric syndromes remains understudied. There is also evidence that certain ophthalmic diseases may serve as markers of geriatric syndromes. To implement a geriatric approach, it is essential to understand how physical status parameters may change in the presence of sensory organ pathologies, particularly the eyes.

OBJECTIVE. To study the association between certain geriatric syndromes and ocular pathologies in elderly patients.

MATERIALS AND METHODS. We analyzed 481 medical records (Form 003-u) of patients admitted to the Arkhangelsk Veterans' War Hospital between 2019 and 2023 (mean age: (80.96 ± 0.24) years old). All patients underwent a Comprehensive Geriatric Assessment (CGA), including evaluations of gait speed, balance, nutritional status (MNA scale), functionality (Barthel Index), the Timed Up and Go (TUG) test, and fall risk assessment (Morse Fall Scale). Criteria for geriatric syndromes were based on the 2021 Clinical Guidelines for Frailty in Old Age. An ophthalmologist examined all patients using standard diagnostic methods. Ophthalmic diagnoses were recorded as «present» or «absent».

Statistical analysis included frequency distribution and Pearson’s chi-square test, processed using Stata.

RESULTS. The most common ocular pathologies in the study cohort were glaucoma (27.9%), cataract (74.5%), and retinal angiosclerosis (96.7%). Uncorrected vision was prevalent in 52.4% of patients. Sex-based associations revealed:

– Visual acuity impairment (equal in men and women, slightly better in men).

Glaucoma (3.5 times more frequent in women).

No other statistically significant sex-linked ophthalmic associations were found.

Ocular diseases showed significant correlations with geriatric syndromes:

• Glaucoma increased the likelihood of slow gait speed by 74%.
• Cataract worsened gait speed by 82%.
• Secondary retinopathy increased the prevalence of slow gait by 115%.
• Uncorrected refractive errors were associated with 77% worse TUG test results (adjusted for sex and age).
• Uncorrected bilateral vision impairment correlated with a higher fall risk (TUG test).
• Patients with uncorrected vision had a 51% higher risk of falls.

No significant associations were found between ophthalmic pathologies and balance impairments.

• Glaucoma increased the risk of malnutrition by 82%, while secondary retinopathy raised it by 84%.

CONCLUSION. These associations can inform personalized rehabilitation programs in geriatric practice and support the integration of geriatric principles into ophthalmic care.