Vision, Eye Disease, and the Onset of Balance Problems: The Canadian Longitudinal Study on Aging

• Published in: American journal of ophthalmology 2021-11, Vol.231, p.170-178
• Main Authors: Kahiel, Zaina, Grant, Alyssa, Aubin, Marie-Josée, Buhrmann, Ralf, Kergoat, Marie-Jeanne, Freeman, Ellen E.
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adult; Age; Aging; Blindness; Body mass index; Canada - epidemiology; Cataracts; Consent; Data collection; Diabetes; Diabetic retinopathy; Ethics; Eye diseases; Glaucoma; Humans; Longitudinal Studies; Macular degeneration; Prospective Studies; Smoking; Stroke; Variables; Vision Disorders - diagnosis; Vision Disorders - epidemiology; Visual impairment
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2021.06.008

•People with worse visual acuity were more likely to develop balance problems.•Those with a history of cataract were more likely to develop balance problems.•Efforts to improve the balance of visually impaired people are needed. To understand the relationship between visual impairment, self-reported eye disease, and the onset of balance problems. Population-based prospective cohort study. Baseline and 3-year follow-up data were used from the Canadian Longitudinal Study on Aging. The Comprehensive Cohort included 30,097 adults aged 45 to 85 years recruited from 11 sites across 7 provinces. Balance was measured using the 1-leg balance test. Those who could not stand on 1 leg for at least 60 seconds failed the balance test. Presenting visual acuity was measured using the Early Treatment of Diabetic Retinopathy Study chart. Participants were asked about a previous diagnosis of cataract, macular degeneration, or glaucoma. Logistic regression was used. Of the 12,158 people who could stand for 60 seconds on 1 leg at baseline, 18% were unable to do the same 3 years later. For each line worse of visual acuity, there was a 15% higher odds of failing the balance test at follow-up (odds ratio [OR] = 1.15, 95% confidence interval [CI] 1.10, 1.20) after adjustment. Those with a report of a former (OR = 1.59, 95% CI 1.17, 2.16) or current cataract (OR = 1.31, 95% CI 1.01, 1.68) were more likely to fail the test at follow-up. Age-related macular degeneration and glaucoma were not associated with failure on the balance test. These data provide longitudinal evidence that vision loss increases the odds of balance problems over a 3-year period. Efforts to prevent avoidable vision loss are needed, as are efforts to improve the balance of visually impaired people.