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

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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.

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Data availability

All data generated or analyzed during this study are included in this article and its supplementary material files. Further inquiries can be directed to the corresponding author.

Code availability

Not applicable.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy

    Matteo Ripa & Stanislao Rizzo

  2. Catholic University “Sacro Cuore”, Rome, Italy

    Matteo Ripa, Chiara Schipa, Stanislao Rizzo, Liliana Sollazzi & Paola Aceto

  3. Department of Emergency, Anesthesiological and Reanimation Sciences, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Largo A. Gemelli, 8, 00168, Rome, Italy

    Chiara Schipa, Liliana Sollazzi & Paola Aceto

  4. Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy

    Stanislao Rizzo

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Contributions

MR, CS, LS, PA, and SR: contributed to conceptualization and supervision. MR and PA: were involved in data curation, formal analysis, investigation, methodology, visualization, and writing of original drafts. MR and PA: contributed to writing–review, and editing. All authors read and approved the final manuscript.

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Correspondence to Chiara Schipa.

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Ripa, M., Schipa, C., Rizzo, S. et al. 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 35, 227–244 (2023). https://doi.org/10.1007/s40520-022-02296-5

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