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Visual impairment screening at the Geriatric Frailty Clinic for Assessment of Frailty and Prevention of Disability at the Gérontopôle

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The journal of nutrition, health & aging

Abstract

Objectives

To evaluate visual performance and factors associated with abnormal vision in patients screened for frailty at the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability at Toulouse University Hospital.

Design

Retrospective, observational cross-sectional, single-centre study.

Setting

Institutional practice.

Participants

Patients were screened for frailty during a single-day hospital stay between October 2011 and October 2014 (n = 1648).

Measurements

Collected medical records included sociodemographic data (including living environment and educational level), anthropometric data, and clinical data. The general evaluation included the patient’s functional status using the Activities of Daily Living (ADL) scale and the Instrumental Activity of Daily Living (IADL) scale, the Mini-Mental State Examination (MMSE) for cognition testing, and the Short Physical Performance Battery (SPPB) for physical performance. We also examined Body Mass Index (BMI), the Mini-Nutritional Assessment (MNA), and the Hearing Handicap Inventory for the Elderly Screening (HHIE-S) tool. The ophthalmologic evaluation included assessing visual acuity using the Snellen decimal chart for distant vision, and the Parinaud chart for near vision. Patients were divided into groups based on normal distant/near vision (NDV and NNV groups) and abnormal distant/near vision (ADV and ANV groups). Abnormal distant or near vision was defined as visual acuity inferior to 20/40 or superior to a Parinaud score of 2, in at least one eye. Associations with frailty-associated factors were evaluated in both groups.

Results

The mean age of the population was 82.6 ± 6.2 years. The gender distribution was 1,061 females (64.4%) and 587 males (35.6%). According to the Fried criteria, 619 patients (41.1%) were pre-frail and 771 (51.1%) were frail. Distant and near vision data were available for 1425 and 1426 patients, respectively. Distant vision was abnormal for 437 patients (30.7%). Near vision was abnormal for 199 patients (14%). Multiple regression analysis showed that abnormal distant vision as well as abnormal near vision were independently associated with greater age (P < 0.01), lower educational level (P < 0.05), lower performance on the MMSE (P < 0.001), and lower autonomy (P < 0.02), after controlling for age, gender, educational level, Fried criteria, and MMSE score.

Conclusion

The high prevalence of visual disorders observed in the study population and their association with lower autonomy and cognitive impairment emphasises the need for systematic screening of visual impairments in the elderly. Frailty was not found to be independently associated with abnormal vision.

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Authors and Affiliations

  1. Retina Unit, Ophthalmology Department, Hôpital Pierre Paul Riquet, Toulouse University Hospital, Place Baylac, Toulouse, France

    Vincent Soler, N. Tavassoli & F. Malecaze

  2. Université Toulouse III, 118 route de Narbonne, 31062, Toulouse CEDEX 9, France

    Vincent Soler, M. Cassagne & F. Malecaze

  3. Laboratoire GR2DE, EA4555, Centre de Physiopathologie Toulouse-Purpan, Toulouse University Hospital, Place Baylac, Toulouse, France

    Vincent Soler, M. Cassagne & F. Malecaze

  4. Gerontopole, Toulouse University Hospital, Pavillon Junod 170, avenue de Casselardit TSA 40031, 31059, Toulouse Cedex 9, France

    S. Sourdet, L. Balardy, G. Abellan Van Kan, D. Brechemier, M. E. Rouge Bugat, N. Tavassoli, F. Nourhashemi & B. Vellas

  5. Institute of Aging, University of Toulouse III - Paul Sabatier, Toulouse, France

    M. E. Rouge Bugat & F. Nourhashemi

  6. Faculté de Médecine, Department of Primary Care of Toulouse University Hospital, 133 Route de Narbonne, 31062, Toulouse Cedex, France

    M. E. Rouge Bugat

  7. Inserm U 1027 Unit, Faculté de médecine, 37 allées Jules Guesde, 31000, Toulouse, France

    M. E. Rouge Bugat

  8. Cornea Unit, Ophthalmology Department, Hôpital Pierre Paul Riquet, Toulouse University Hospital, Place Baylac, 31059, Toulouse, France

    M. Cassagne & F. Malecaze

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  1. Vincent Soler
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  2. S. Sourdet
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  3. L. Balardy
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  11. B. Vellas
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Correspondence to Vincent Soler.

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Soler, V., Sourdet, S., Balardy, L. et al. Visual impairment screening at the Geriatric Frailty Clinic for Assessment of Frailty and Prevention of Disability at the Gérontopôle. J Nutr Health Aging 20, 870–877 (2016). https://doi.org/10.1007/s12603-015-0648-z

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  • DOI: https://doi.org/10.1007/s12603-015-0648-z

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