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Physical activity restriction in age-related eye disease: a cross-sectional study exploring fear of falling as a potential mediator.

Nguyen AM, Arora KS, Swenor BK, Friedman DS, Ramulu PY - BMC Geriatr (2015)

Bottom Line: When FoF was added to the model, the RR increased from 0.74 to 0.78, and VF loss severity remained associated with less MVPA at a statistically significant level (p < 0.01).Likewise, 0.1 log units worse CS was associated with 11 % less daily MVPA (RR = 0.89, p < 0.01) amongst AMD subjects.When FoF was added to the model, the RR increased from 0.89 to 1.02, and CS loss was no longer associated with MVPA at a statistically significant level (p = 0.53).

View Article: PubMed Central - PubMed

Affiliation: Wilmer Eye Institute, Johns Hopkins University, 600 North Wolfe Street, Maumenee B-110, Baltimore, MD, 21287, USA. anguye24@jhmi.edu.

ABSTRACT

Background: Fear of falling (FoF) is predictive of decreased physical activity. This study sought to determine if FoF mediates the relationship between decreased vision and physical activity restriction in individuals with glaucoma and age-related macular degeneration (AMD).

Methods: Accelerometers were used to measure physical activity over 1 week in 59 control, 83 glaucoma, and 58 AMD subjects. Subjects completed the University of Illinois at Chicago Fear of Falling Questionnaire, and the extent of FoF was estimated using Rasch analysis. In negative binomial models adjusting for demographic, health, and social factors, FoF was investigated as a potential mediator between the severity of visual field (VF) loss (in glaucoma patients) or the severity of contrast sensitivity (CS) loss (in AMD patients) and decreased engagement in physical activity, defined as minutes spent in moderate-to-vigorous physical activity (MVPA) per day.

Results: In multivariate negative binomial regression models, 5-decibels worse VF mean deviation was associated with 26 % less engagement in MVPA [rate ratio (RR) = 0.74, p < 0.01] amongst glaucoma subjects. When FoF was added to the model, the RR increased from 0.74 to 0.78, and VF loss severity remained associated with less MVPA at a statistically significant level (p < 0.01). Likewise, 0.1 log units worse CS was associated with 11 % less daily MVPA (RR = 0.89, p < 0.01) amongst AMD subjects. When FoF was added to the model, the RR increased from 0.89 to 1.02, and CS loss was no longer associated with MVPA at a statistically significant level (p = 0.53).

Conclusions: FoF may mediate the relationship between vision loss and physical activity restriction amongst patients with AMD. Future work should determine optimal strategies for reducing FoF in individuals with vision loss in order to prevent the deleterious effects of physical activity restriction.

No MeSH data available.


Related in: MedlinePlus

Distribution of FoF in a control subjects versus glaucoma subjects and b control subjects versus AMD subjects. Fear of falling is presented as Rasch-derived person measures based on participants’ responses to the University of Illinois at Chicago Fear of Falling Questionnaire. A lower fear of falling person measure indicates greater fear of falling in the individual
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Fig1: Distribution of FoF in a control subjects versus glaucoma subjects and b control subjects versus AMD subjects. Fear of falling is presented as Rasch-derived person measures based on participants’ responses to the University of Illinois at Chicago Fear of Falling Questionnaire. A lower fear of falling person measure indicates greater fear of falling in the individual

Mentions: A greater proportion of both the glaucoma and AMD groups had low FoF person measures (greater fear of falling) as compared to controls (Fig. 1). For glaucoma subjects, median time spent engaged in MVPA was 19.7 minutes/day (IQR = 4.5 to 50.1 minutes/day) for those with mild-to-absent FoF, as compared with 5.0 minutes/day (IQR = 0.4 to 14.6 minutes/day; p < 0.01) for those with moderate-to-severe FoF (Fig. 2a). For AMD subjects, median time spent engaged in MVPA was 6 minutes/day among subjects with mild-to-absent FoF (IQR = 1.7 to 41.5 minutes/day), as compared with 0.5 minutes/day (IQR = 0.0 to 2.8 minutes/day p < 0.01) for those with moderate-to-severe FoF (Fig. 2b).Fig. 1


Physical activity restriction in age-related eye disease: a cross-sectional study exploring fear of falling as a potential mediator.

Nguyen AM, Arora KS, Swenor BK, Friedman DS, Ramulu PY - BMC Geriatr (2015)

Distribution of FoF in a control subjects versus glaucoma subjects and b control subjects versus AMD subjects. Fear of falling is presented as Rasch-derived person measures based on participants’ responses to the University of Illinois at Chicago Fear of Falling Questionnaire. A lower fear of falling person measure indicates greater fear of falling in the individual
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4464712&req=5

Fig1: Distribution of FoF in a control subjects versus glaucoma subjects and b control subjects versus AMD subjects. Fear of falling is presented as Rasch-derived person measures based on participants’ responses to the University of Illinois at Chicago Fear of Falling Questionnaire. A lower fear of falling person measure indicates greater fear of falling in the individual
Mentions: A greater proportion of both the glaucoma and AMD groups had low FoF person measures (greater fear of falling) as compared to controls (Fig. 1). For glaucoma subjects, median time spent engaged in MVPA was 19.7 minutes/day (IQR = 4.5 to 50.1 minutes/day) for those with mild-to-absent FoF, as compared with 5.0 minutes/day (IQR = 0.4 to 14.6 minutes/day; p < 0.01) for those with moderate-to-severe FoF (Fig. 2a). For AMD subjects, median time spent engaged in MVPA was 6 minutes/day among subjects with mild-to-absent FoF (IQR = 1.7 to 41.5 minutes/day), as compared with 0.5 minutes/day (IQR = 0.0 to 2.8 minutes/day p < 0.01) for those with moderate-to-severe FoF (Fig. 2b).Fig. 1

Bottom Line: When FoF was added to the model, the RR increased from 0.74 to 0.78, and VF loss severity remained associated with less MVPA at a statistically significant level (p < 0.01).Likewise, 0.1 log units worse CS was associated with 11 % less daily MVPA (RR = 0.89, p < 0.01) amongst AMD subjects.When FoF was added to the model, the RR increased from 0.89 to 1.02, and CS loss was no longer associated with MVPA at a statistically significant level (p = 0.53).

View Article: PubMed Central - PubMed

Affiliation: Wilmer Eye Institute, Johns Hopkins University, 600 North Wolfe Street, Maumenee B-110, Baltimore, MD, 21287, USA. anguye24@jhmi.edu.

ABSTRACT

Background: Fear of falling (FoF) is predictive of decreased physical activity. This study sought to determine if FoF mediates the relationship between decreased vision and physical activity restriction in individuals with glaucoma and age-related macular degeneration (AMD).

Methods: Accelerometers were used to measure physical activity over 1 week in 59 control, 83 glaucoma, and 58 AMD subjects. Subjects completed the University of Illinois at Chicago Fear of Falling Questionnaire, and the extent of FoF was estimated using Rasch analysis. In negative binomial models adjusting for demographic, health, and social factors, FoF was investigated as a potential mediator between the severity of visual field (VF) loss (in glaucoma patients) or the severity of contrast sensitivity (CS) loss (in AMD patients) and decreased engagement in physical activity, defined as minutes spent in moderate-to-vigorous physical activity (MVPA) per day.

Results: In multivariate negative binomial regression models, 5-decibels worse VF mean deviation was associated with 26 % less engagement in MVPA [rate ratio (RR) = 0.74, p < 0.01] amongst glaucoma subjects. When FoF was added to the model, the RR increased from 0.74 to 0.78, and VF loss severity remained associated with less MVPA at a statistically significant level (p < 0.01). Likewise, 0.1 log units worse CS was associated with 11 % less daily MVPA (RR = 0.89, p < 0.01) amongst AMD subjects. When FoF was added to the model, the RR increased from 0.89 to 1.02, and CS loss was no longer associated with MVPA at a statistically significant level (p = 0.53).

Conclusions: FoF may mediate the relationship between vision loss and physical activity restriction amongst patients with AMD. Future work should determine optimal strategies for reducing FoF in individuals with vision loss in order to prevent the deleterious effects of physical activity restriction.

No MeSH data available.


Related in: MedlinePlus