Physical activity and visual difficulties in 36 low- and middle-income countries

Smıth, Lee; Pardhan, Shahina; Gorely, Trish; Barnett, Yvonne; Jacob, Louis; Sánchez, Guillermo Felipe López; Tully, Mark A.; Shin, Jae Il; Koyanagi, Ai

doi:10.1038/s41433-021-01439-8

Cited by 6 publications

(2 citation statements)

References 42 publications

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“…Our findings suggested that our conclusions regarding lighting and physical activity measures, while derived from a population enriched for persons with visual impairment, may also apply older adults without impairment, as our association did not differ by the level of VF damage, though sample size considerations may have made it harder to identify interactions. Literature showed that individuals with visual impairment have lower physical activity overall, 24 but they also spend more time at home and likely get most of their physical activity doing household tasks, such as cooking, sweeping, cleaning, etc. 9 Thus, improved lighting at home may play an especially important role in improving physical activity in older individuals with visual impairment.…”

Section: Discussionmentioning

confidence: 99%

Visual Impairment and Real-World Home Physical Activity With Home Environment in an Older Population

Banerjee,

Mihailovic,

Miller

et al. 2024

JAMA Ophthalmol

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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.

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Section: Discussionmentioning

confidence: 99%

Visual Impairment and Real-World Home Physical Activity With Home Environment in an Older Population

Banerjee,

Mihailovic,

Miller

et al. 2024

JAMA Ophthalmol

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“…Arthritis and chronic back pain are likely associated with sarcopenia owing to these conditions increasing levels of low-grade inflammation and reducing levels of physical activity [33,34]. In terms of vision and hearing problems, an increase in sarcopenia among these populations may again be owing to a low level of physical activity and high sitting time [35]. The association between multimorbidity and sarcopenia may be explained by the accumulative effect of single chronic conditions and their increased risk for sarcopenia.…”

Section: Interpretation Of the Findingsmentioning

confidence: 99%

Physical Multimorbidity and Sarcopenia among Adults Aged ≥65 Years in Low- and Middle-Income Countries

et al. 2022

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Introduction: Physical multimorbidity is plausibly linked to sarcopenia. However, to date, only a few studies exist on this topic, and none have examined this association in low- and middle-income countries (LMICs). Thus, we aimed to investigate the association between multimorbidity and sarcopenia in a sample of older adults from six LMICs (China, Ghana, India, Mexico, Russia, South Africa). Methods: Cross-sectional, community-based data from the WHO Study on Global Ageing and Adult Health (SAGE) were analysed. Sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. A total of 11 physical chronic conditions were assessed and multimorbidity referred to ≥2 chronic conditions. Multivariable logistic regression analysis was conducted. Results: Data on 14,585 adults aged ≥65 years were analysed (mean age 72.6 years, SD 11.5 years; 53.7% females). Adjusted estimates showed that compared to no chronic physical conditions, ≥2 conditions are significantly associated with 1.49 (95% CI = 1.02–2.19) and 2.52 (95% CI = 1.53–4.15) times higher odds for sarcopenia and severe sarcopenia, respectively. Conclusions: In this large sample of older adults from LMICs, physical multimorbidity was significantly associated with sarcopenia and severe sarcopenia. Our study results tentatively suggest that targeting those with multimorbidity may aid in the prevention of sarcopenia, pending future longitudinal research.

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The Association Between Objectively Measured Vision Impairment and Self-Reported Physical Activity Among 34,129 Adults Aged ≥50 Years in Six Low- and Middle-Income Countries

Smith¹,

Pardhan²,

Gorely³

et al. 2022

Journal of Aging and Physical Activity

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The authors investigated the association between vision impairment and physical activity among older adults from low- and middle-income countries. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better seeing eye. Physical activity was assessed by the Global Physical Activity Questionnaire. Multivariable logistic regression and meta-analysis were conducted to assess associations. The sample included 34,129 individuals aged 50–114 years (mean [SD] age 62.4 [16.0] years; 47.9% male). After adjustment for confounders, near vision impairment was not significantly associated with low physical activity, but far vision impairment showed a significant association (odds ratio = 1.32; 95% confidence interval [1.17, 1.49], I2 = 0.0%). Far vision impairment was dose-dependently associated with low physical activity (e.g., severe [<6/10] vs. no [≥6/12] far vision impairment; odds ratio = 1.80; 95% confidence interval [1.03, 3.15]). Interventions to address low levels of physical activity in the visually impaired in low- and middle-income countries should target those with far vision impairment.

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Physical activity and visual difficulties in 36 low- and middle-income countries

Cited by 6 publications

References 42 publications

Visual Impairment and Real-World Home Physical Activity With Home Environment in an Older Population

Visual Impairment and Real-World Home Physical Activity With Home Environment in an Older Population

Physical Multimorbidity and Sarcopenia among Adults Aged ≥65 Years in Low- and Middle-Income Countries

The Association Between Objectively Measured Vision Impairment and Self-Reported Physical Activity Among 34,129 Adults Aged ≥50 Years in Six Low- and Middle-Income Countries

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