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

Aging Clin Exp Res. 2023 Feb;35(2):227-244. doi: 10.1007/s40520-022-02296-5. Epub 2022 Nov 11.

Abstract

Background: Frailty is linked to poor health outcomes later in life. Recent research suggests that visual loss is a possible modifiable risk factor for frailty.

Aims: To analyze the relationship between visual impairment (VI) and frailty and investigate whether it can increase the risk of frailty in older adults.

Methods: 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 65 years 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.

Results: 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.

Conclusions: Visual impairment increases the risk of frailty in later life and should be accurately assessed in frail older adults.

Keywords: Age-related vision loss; Elderly patients; Frail; Frailty; Poor vision; Visual impairment.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Frail Elderly
  • Frailty*
  • Humans
  • Longitudinal Studies
  • Risk Factors