Contrast Sensitivity Impairment Is Associated With Limitations of Physical Functioning and Activities of Daily Living Among Older Adults

Abstract

Purpose: Contrast sensitivity (CS), the ability to see objects against their background, is an important component of visual function. The effect of contrast sensitivity impairment (CSI) on physical functioning (PF) is not well documented. Methods: This study obtained data from the Aging, Demographics, and Memory Study. Baseline CS was measured, and self-reported PF, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) were assessed biennially. Results: The sample included 263 individuals with a mean (SD) age: 82.1(5.3). Participants with severe CSI had PF limitation scores 1.05 points higher (95% CI: 0.07, 2.04) than those without CSI. Odds of ADL/IADL limitations were 4.45 times (95% CI: 2.00, 9.92) and 74% (95% CI: 1.24, 2.45) higher for those with severe CSI and moderate CSI. Older adults with severe CSI had 2.79 times (95% CI: 1.21, 6.43) higher hazard of incident ADL/IADL limitations. Conclusions: CSI is associated with PF and ADL/IADL limitations.

Keywords

contrast sensitivity impairment vision impairment physical functioning activities of daily living instrumental activities of daily living

Get full access to this article

View all access options for this article.

References

Almidani

Miller

Varadaraj

Mihailovic

Swenor

B. K.

Ramulu

P. Y.

(2024). Vision impairment and psychosocial function in US adults. JAMA Ophthalmology, 142(4), 283–291. https://doi.org/10.1001/jamaophthalmol.2023.6943

Arditi

(2005). Improving the design of the letter contrast sensitivity test. Investigative Ophthalmology & Visual Science, 46(6), 2225–2229. https://doi.org/10.1167/iovs.04-1198

Bloomberg

Dugravot

Landré

Britton

Steptoe

Singh-Manoux

Sabia

(2021). Sex differences in functional limitations and the role of socioeconomic factors: A multi-cohort analysis. The Lancet. Healthy Longevity, 2(12), e780–e790. https://doi.org/10.1016/S2666-7568(21)00249-X

Crews

J. E.

Chou

C. F.

Sekar

Saaddine

J. B.

(2017). The prevalence of chronic conditions and poor health among people with and without vision impairment, aged ≥65 Years, 2010-2014. American Journal of Ophthalmology, 182, 18–30. https://doi.org/10.1016/j.ajo.2017.06.038

de Boer

M. R.

Pluijm

S. M.

Lips

Moll

A. C.

Völker-Dieben

H. J.

Deeg

D. J.

van Rens

G. H.

(2004). Different aspects of visual impairment as risk factors for falls and fractures in older men and women. Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research, 19(9), 1539–1547. https://doi.org/10.1359/JBMR.040504

Duggan

Donoghue

Kenny

R. A.

Cronin

Loughman

Finucane

(2017). Time to refocus assessment of vision in older adults? Contrast sensitivity but not visual acuity is associated with gait in older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 72(12), 1663–1668. https://doi.org/10.1093/gerona/glx021

Feng

Y. R.

Meuleners

L. B.

Fraser

M. L.

Brameld

K. J.

Agramunt

(2018). The impact of first and second eye cataract surgeries on falls: A prospective cohort study. Clinical Interventions in Aging, 13, 1457–1464. https://doi.org/10.2147/CIA.S164419

Flaharty

Niziol

L. M.

Woodward

M. A.

Elam

Bicket

Killeen

O. J.

Zhang

Johnson

Kershaw

John

D. A.

Wood

S. K.

Musch

D. C.

Newman-Casey

P. A.

(2024). Association of contrast sensitivity with eye disease and vision-related quality of life. American Journal of Ophthalmology, 261, 176–186. https://doi.org/10.1016/j.ajo.2024.01.021

Guo

Arsiwala

L. T.

Dong

Mihailovic

Ramulu

P. Y.

Sharrett

A. R.

Mosley

Abraham

A. G.

(2021). Visual function, physical function, and activities of daily living in two aging communities. Translational Vision Science & Technology, 10(14), 15. https://doi.org/10.1167/tvst.10.14.15

10.

Harwood

R. H.

Foss

A. J.

Osborn

Gregson

R. M.

Zaman

Masud

(2005). Falls and health status in elderly women following first eye cataract surgery: A randomised controlled trial. The British Journal of Ophthalmology, 89(1), 53–59. https://doi.org/10.1136/bjo.2004.049478

11.

Jin

Zhou

Stagg

B. C.

Ehrlich

J. R.

(2024). Association between vision impairment and increased prevalence of falls in older US adults. Journal of the American Geriatrics Society, 72(5), 1373–1383. https://doi.org/10.1111/jgs.18879

12.

Karvonen-Gutierrez

C. A.

Hood

M. M.

Moroi

Musch

D. C.

Kumar

Wood

S. D.

(2022). Disparities in vision impairment and eye diseases among early late-life women: The study of women's health across the nation, Michigan site. Seminars in Ophthalmology, 37(7-8), 887–894. https://doi.org/10.1080/08820538.2022.2072689

13.

Kaur

Gurnani

(2023). Contrast sensitivity. In StatPearls. StatPearls Publishing.

14.

Killeen

O. J.

De Lott

L. B.

Zhou

Rein

Reed

Swenor

B. K.

Ehrlich

J. R.

(2023a). Population prevalence of vision impairment in US adults 71 Years and older: The national health and aging trends study. JAMA Ophthalmology, 141(2), 197–204. https://doi.org/10.1001/jamaophthalmol.2022.5840

15.

Killeen

O. J.

Zhou

Ehrlich

J. R.

(2023b). Objectively measured visual impairment and dementia prevalence in older adults in the US. JAMA Ophthalmology, 141(8), 786–790. https://doi.org/10.1001/jamaophthalmol.2023.2854

16.

Kroenke

Spitzer

R. L.

Williams

J. B.

(2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

17.

Laitinen

Sainio

Koskinen

Rudanko

S. L.

Laatikainen

Aromaa

(2007). The association between visual acuity and functional limitations: Findings from a nationally representative population survey. Ophthalmic Epidemiology, 14(6), 333–342. https://doi.org/10.1080/01658100701473713

18.

Langa

K. M.

Plassman

B. L.

Wallace

R. B.

Herzog

A. R.

Heeringa

S. G.

Ofstedal

M. B.

Burke

J. R.

Fisher

G. G.

Fultz

N. H.

Hurd

M. D.

Potter

G. G.

Rodgers

W. L.

Steffens

D. C.

Weir

D. R.

Willis

R. J.

(2005). The aging, demographics, and memory study: Study design and methods. Neuroepidemiology, 25(4), 181–191. https://doi.org/10.1159/000087448

19.

Leung

J. C.

Kwok

T. C.

Chan

D. C.

Yuen

K. W.

Kwok

A. W.

Choy

D. T.

Lau

E. M.

Leung

P. C.

(2012). Visual functioning and quality of life among the older people in Hong Kong. International Journal of Geriatric Psychiatry, 27(8), 807–815. https://doi.org/10.1002/gps.2789

20.

Logue Cook

R. N.

Davis

M. A.

Hasson

R. E.

Kinnett-Hopkins

Brown

S. H.

(2024). Racial/ethnic differences in self-reported upper limb limitations among U.S. Older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 79(7), glae104. https://doi.org/10.1093/gerona/glae104

21.

Lord

S. R.

Dayhew

Howland

(2002). Multifocal glasses impair edge-contrast sensitivity and depth perception and increase the risk of falls in older people. Journal of the American Geriatrics Society, 50(11), 1760–1766. https://doi.org/10.1046/j.1532-5415.2002.50502.x

22.

Mars Perceptrix Corporation . (2024, May) The Mars contrast sensitivity test. https://marsperceptrix.com/wp-content/uploads/Mars-CS-Test-User-Manual-rev-20240719.pdf

23.

Mehta

Czanner

Harding

Newsham

Robinson

(2022). Visual risk factors for falls in older adults: A case-control study. BMC Geriatrics, 22(1), 134. https://doi.org/10.1186/s12877-022-02784-3

24.

Morris

J. C.

(1993). The clinical dementia rating (CDR): Current version and scoring rules. Neurology, 43(11), 2412–2414. https://doi.org/10.1212/wnl.43.11.2412-a

25.

Nagarajan

Assi

Varadaraj

Motaghi

Sun

Couser

Ehrlich

J. R.

Whitson

Swenor

B. K.

(2022). Vision impairment and cognitive decline among older adults: A systematic review. BMJ Open, 12(1), Article e047929. https://doi.org/10.1136/bmjopen-2020-047929

26.

Nagi

S. Z.

(1976). An epidemiology of disability among adults in the United States. The Milbank Memorial Fund Quarterly. Health and Society, 54(4), 439–467.

27.

Okoro

C. A.

Hollis

N. D.

Cyrus

A. C.

Griffin-Blake

(2018). Prevalence of disabilities and health care access by disability status and type among adults - United States, 2016. MMWR. Morbidity and Mortality Weekly Report, 67(32), 882–887. https://doi.org/10.15585/mmwr.mm6732a3

28.

Owsley

Sekuler

Siemsen

(1983). Contrast sensitivity throughout adulthood. Vision Research, 23(7), 689–699. https://doi.org/10.1016/0042-6989(83)90210-9

29.

Rubin

G. S.

West

S. K.

Muñoz

Bandeen-Roche

Zeger

Schein

Fried

L. P.

(1997). A comprehensive assessment of visual impairment in a population of older Americans. The SEE Study. Salisbury Eye Evaluation Project. Investigative Ophthalmology & Visual Science, 38(3), 557–568.

30.

Salive

M. E.

Guralnik

Glynn

R. J.

Christen

Wallace

R. B.

Ostfeld

A. M.

(1994). Association of visual impairment with mobility and physical function. Journal of the American Geriatrics Society, 42(3), 287–292. https://doi.org/10.1111/j.1532-5415.1994.tb01753.x

31.

Sonnega

Faul

J. D.

Ofstedal

M. B.

Langa

K. M.

Phillips

J. W.

Weir

D. R.

(2014). Cohort profile: The health and retirement study (HRS). International Journal of Epidemiology, 43(2), 576–585. https://doi.org/10.1093/ije/dyu067

32.

Swenor

B. K.

Muñoz

West

S. K.

(2014). A longitudinal study of the association between visual impairment and mobility performance in older adults: The salisbury eye evaluation study. American Journal of Epidemiology, 179(3), 313–322. https://doi.org/10.1093/aje/kwt257

33.

Swenor

B. K.

Simonsick

E. M.

Ferrucci

Newman

A. B.

Rubin

Wilson

Health, Aging and Body Composition Study (2015). Visual impairment and incident mobility limitations: The health, aging and body composition study. Journal of the American Geriatrics Society, 63(1), 46–54. https://doi.org/10.1111/jgs.13183

34.

Tanabe

Tabuchi

Shojo

Yamauchi

Takase

(2020). Comparison of visual performance between monofocal and multifocal intraocular lenses of the same material and basic design. Scientific Reports, 10(1), Article 15490. https://doi.org/10.1038/s41598-020-72473-x

35.

Thayaparan

Crossland

M. D.

Rubin

G. S.

(2007). Clinical assessment of two new contrast sensitivity charts. The British Journal of Ophthalmology, 91(6), 749–752. https://doi.org/10.1136/bjo.2006.109280

36.

Thompson

A. C.

Chen

Miller

M. E.

Webb

C. C.

Williamson

J. D.

Marsh

A. P.

Hugenschmidt

C. E.

Baker

L. D.

Laurienti

P. J.

Kritchevsky

S. B.

(2023a). Association between contrast sensitivity and physical function in cognitively healthy older adults: The brain networks and mobility function study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 78(8), 1513–1521. https://doi.org/10.1093/gerona/glad060

37.

Thompson

A. C.

Johnson

Miller

M. E.

Williamson

J. D.

Newman

A. B.

Cummings

Cawthon

Kritchevsky

S. B.

(2023b). The relationship between visual function and physical performance in the Study of Muscle, Mobility and Aging (SOMMA). PloS One, 18(9), Article e0292079. https://doi.org/10.1371/journal.pone.0292079

38.

Thompson

A. C.

Miller

M. E.

Webb

C. C.

Williamson

J. D.

Kritchevsky

S. B.

(2023c). Relationship of self-reported and performance-based visual function with performance-based measures of physical function: The health ABC study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 78(11), 2060–2069. https://doi.org/10.1093/gerona/glac225

39.

K. G.

Meuleners

Bulsara

Fraser

M. L.

Duong

D. V.

Huynh

V. A.

Phi

T. D.

Tran

H. H.

Nguyen

N. D.

(2014). A longitudinal cohort study of the impact of first- and both-eye cataract surgery on falls and other injuries in Vietnam. Clinical Interventions in Aging, 9, 743–751. https://doi.org/10.2147/CIA.S61224

40.

Varma

Vajaranant

T. S.

Burkemper

Torres

Hsu

Choudhury

McKean-Cowdin

(2016). Visual impairment and blindness in adults in the United States: Demographic and geographic variations from 2015 to 2050. JAMA Ophthalmology, 134(7), 802–809. https://doi.org/10.1001/jamaophthalmol.2016.1284

41.

Verbrugge

L. M.

Jette

A. M.

(1994). The disablement process. Social Science & Medicine (1982), 38(1), 1–14. https://doi.org/10.1016/0277-9536(94)90294-1

42.

Ward

M. E.

Gelfand

J. M.

Lui

L. Y.

Green

A. J.

Stone

Pedula

K. L.

Cummings

S. R.

Yaffe

(2018). Reduced contrast sensitivity among older women is associated with increased risk of cognitive impairment. Annals of Neurology, 83(4), 730–738. https://doi.org/10.1002/ana.25196

43.

West

C. G.

Gildengorin

Haegerstrom-Portnoy

Schneck

M. E.

Lott

Brabyn

J. A.

(2002). Is vision function related to physical functional ability in older adults? Journal of the American Geriatrics Society, 50(1), 136–145. https://doi.org/10.1046/j.1532-5415.2002.50019.x

44.

World Health Organization . (2001). International classification of functioning, disability and health (ICF). World Health Organization.

45.

World Health Organization (2025, January). ICD-11 for mortality and morbidity statistics. 9D90 vision impairment including blindness. https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1103667651

46.

Zheng

D. D.

Bokman

C. L.

Lam

B. L.

Christ

S. L.

Swenor

B. K.

West

S. K.

Muñoz

B. E.

Tannenbaum

S. L.

Lee

D. J.

(2016). Longitudinal relationships between visual acuity and severe depressive symptoms in older adults: The salisbury eye evaluation study. Aging & Mental Health, 20(3), 295–302. https://doi.org/10.1080/13607863.2015.1008985

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.30 MB