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Visual Impairment and Real-World Home Physical Activity With Home Environment in an Older Population
JAMA Ophthalmology ( IF 8.1 ) Pub Date : 2024-02-08 , DOI: 10.1001/jamaophthalmol.2023.6436
Seema Banerjee 1 , Aleksandra Mihailovic 1 , Rhonda Miller 1 , Jian-Yu E 1, 2 , Laura N. Gitlin 3 , Yingzi Xiong 1 , Sheila West 1 , David S. Friedman 4 , Pradeep Y. Ramulu 1
Affiliation  

ImportancePhysical activity levels are lower in visual impairment. However, additional factors, such as home environmental features, which can modify physical activity in this group, are unknown.ObjectiveTo investigate the association between home environment features and home physical activity in patients with visual impairment.Design, Setting, and ParticipantsThis cross-sectional study of clinical patients included participants with glaucoma suspect and primary glaucoma who were 60 years or older with varying degrees of visual field damage. Study participants were recruited from the Johns Hopkins Wilmer Eye Institute Glaucoma Clinic, Baltimore, Maryland, from September 2013 through March 2015. Data were analyzed from December 19, 2022, through December 25, 2022.Main Outcomes and MeasuresTotal in-home steps taken per day was the primary outcome measure; time in daily home physical activity and nonsedentary activity were secondary outcomes.ResultsA total of 153 participants were included in analyses with mean age of 71 (SD, 7.8) years and 71 were female (46%). Sixty percent had more than 1 comorbid illness, about one-third took 5 or more prescription drugs, and median daily home steps were 1137. Median integrated visual field sensitivity was 28 dB. Better-eye median visual acuity in logMAR was 0.05 (20/22 Snellen equivalent). For every 0.1-log unit increment in average measured home lighting, participants took 5% more daily steps (rate ratio [RR], 1.05; 95% CI, 1.00-1.10; P = .04) and had a 3% faster average daily peak cadence (RR, 1.03; 95% CI, 1.01-1.05; P = .01). The average number of nonsedentary activity minutes (RR, 1.04; 95% CI, 1.00-1.07; P = .06), average bout duration (β = 0.03; 95% CI, 0.00-.07; P = .06), and activity fragmentation (β = −0.06; 95% CI, −0.13 to 0.00; P = .06) showed associations with home lighting. The number of hazards was not associated with any activity metric (steps: RR, 1.14; 95% CI, 0.96-1.34; P = .13; peak cadence: RR, 1.00; 95% CI, 0.93-1.08; P = .98; and nonsedentary time: RR, 1.11; 95% CI, 0.98-1.26; P = .11), nor was the frequency of hazards.Conclusions and RelevanceIn this study, results demonstrated that home environment features, particularly lighting, may influence home activity metrics in older adults with visual impairment. Further prospective studies would be needed to confirm if home modifications can improve at-home activity.

中文翻译:

老年人的视觉障碍和现实世界的家庭身体活动与家庭环境

重要性视力障碍患者的体力活动水平较低。然而,其他因素,例如可以改变该组身体活动的家庭环境特征,尚不清楚。目的调查视力障碍患者的家庭环境特征和家庭身体活动之间的关联。设计、设置和参与者这个横断面临床患者的研究包括 60 岁或以上患有不同程度视野损伤的疑似青光眼和原发性青光眼的参与者。研究参与者于 2013 年 9 月至 2015 年 3 月从马里兰州巴尔的摩约翰霍普金斯威尔默眼科研究所青光眼诊所招募。数据分析时间为 2022 年 12 月 19 日至 2022 年 12 月 25 日。主要结果和措施天是主要结果指标;日常家庭体力活动和非久坐活动的时间是次要结果。 结果 分析中总共纳入了 153 名参与者,平均年龄为 71 (SD, 7.8) 岁,其中 71 名是女性 (46%)。60% 的人患有超过 1 种共存疾病,约三分之一的人服用 5 种或更多处方药,每日回家步数中位数为 1137。综合视野敏感度中位数为 28 dB。logMAR 中更好眼中位视力为 0.05(20/22 Snellen 等效值)。平均测量的家庭照明每增加 0.1 个对数单位,参与者每天的步数就会增加 5%(比率 [RR],1.05;95% CI,1.00-1.10;= .04),平均每日峰值踏频快了 3%(RR,1.03;95% CI,1.01-1.05;= .01)。平均非久坐活动分钟数(RR,1.04;95% CI,1.00-1.07;= .06),平均回合持续时间 (β = 0.03;95% CI,0.00-.07;= .06) 和活性碎片 (β = -0.06; 95% CI, -0.13 至 0.00;= .06) 显示与家庭照明的关联。危险数量与任何活动指标均无关(步骤:RR,1.14;95% CI,0.96-1.34;= .13;峰值踏频:RR,1.00;95% CI,0.93-1.08;= .98;非久坐时间:RR,1.11;95% CI,0.98-1.26;= .11),危险的频率也没有。结论和相关性在这项研究中,结果表明家庭环境特征,特别是照明,可能会影响视力障碍老年人的家庭活动指标。需要进一步的前瞻性研究来确认家居改造是否可以改善家庭活动。
更新日期:2024-02-08
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