Does visual impairment affect mobility over time? The salisbury eye evaluation study

Purpose. To determine if the odds of mobility disability increases at a different rate among visually impaired (VI) as compared with nonvisually impaired (NVI) over an 8-year period. Methods. A total of 2520 Salisbury Eye Evaluation Study participants were followed 2, 6, and 8 years after baseline. VI was defined as best-corrected visual acuity worse than 20/40, or visual field of approximately less than 20°. Self-reported difficulty with three tasks was assessed at each visit: walking up 10 steps, walking down 10 steps, and walking 150 feet. Generalized estimating equation models included a 6-year spline, and explored differences in mobility difficulty trajectories by including an interaction between VI status and the spline terms. Odds ratios (OR) and 95% confidence intervals (CI) compared mobility difficulty for each task by VI status. Results. At baseline, the VI were significantly more likely to report difficulty mobility tasks than the NVI (OR_{difficultywalkingup10steps} = 1.37, CI: 1.02-1.80; OR_{difficultywalkingdown10steps} = 1.55, CI: 1.16-2.08; OR_{difficultywalking150feet} = 1.50, CI: 1.10-2.04). The trajectory of mobility disability did not differ by VI status from baseline to the 6-year visit. However, the difference between the VI and NVI declined at the 8-year visit, which may be due to loss of VI participants at risk of developing mobility difficulty. Conclusions. The VI were more likely to report mobility disability than the NVI, but the trajectory of mobility disability was not steeper among the VI as compared to the NVI over the study period.