Real-World Assessment of Physical Activity in Glaucoma Using an Accelerometer

doi:10.1016/j.ophtha.2012.01.013

Ophthalmology

Volume 119, Issue 6, June 2012, Pages 1159-1166

https://doi.org/10.1016/j.ophtha.2012.01.013 Get rights and content

Objective

To determine the association between glaucomatous visual field (VF) loss and the amount of physical activity and walking in normal life.

Design

Prospective, observational study.

Participants

Glaucoma suspects without significant VF or visual acuity loss (controls) and glaucoma subjects with bilateral VF loss between 60 and 80 years of age.

Methods

Participants wore an accelerometer over 7 days of normal activity.

Main Outcome Measures

Daily minutes of moderate or vigorous physical activity (MVPA) was the primary measure. Steps per day was a secondary measure.

Results

Fifty-eight controls and 83 glaucoma subjects provided sufficient study days for analysis. Control and glaucoma subjects were similar in age, race, gender, employment status, cognitive ability, and comorbid illness (P>0.1 for all). Better-eye VF mean deviation (MD) averaged 0.0 decibels (dB) in controls and −11.1 dB in glaucoma subjects. The median control subject engaged in 16.1 minutes of MVPA daily and walked 5891 steps/day, as compared with 12.9 minutes of MVPA daily (P = 0.25) and 5004 steps/day (P = 0.05) for the median glaucoma subject. In multivariate models, glaucoma was associated with 21% less MVPA (95% confidence interval [CI], −53% to 32%; P = 0.37) and 12% fewer steps per day (95% CI, −22% to 9%; P = 0.21) than controls, although differences were not statistically significant. There was a significant dose response relating VF loss to decreased activity, with each 5 dB decrement in the better-eye VF associated with 17% less MVPA (95% CI, −30% to −2%; P = 0.03) and 10% fewer steps per day (95% CI, −16% to −5%; P = 0.001). Glaucoma subjects in the most severe tertile of VF damage (better-eye VF MD worse than −13.5 dB) engaged in 66% less MVPA than controls (95% CI, −82% to −37%; P = 0.001) and took 31% fewer steps per day (95% CI, −44% to −15%; P = 0.001). Other significant predictors of decreased physical activity included older age, comorbid illness, depressive symptoms, and higher body mass index.

Conclusions

Overall, no significant difference in physical activity was found between individuals with and without glaucoma, although substantial reductions in physical activity and walking were noted with greater levels of VF loss. Further study is needed to characterize better the relationship between glaucoma and physical activity.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Patients and Methods

All study procedures were approved by the Institutional Review Board of Johns Hopkins School of Medicine. Study participants gave written informed consent and completed the study procedures between July 2009 and June 2011.

Results

Sixty control subjects and 85 glaucoma subjects were enrolled in the study. Two control and 2 glaucoma subjects had fewer than 2 valid study days and were excluded from all analyses except for those using generalized estimating equations. Included glaucoma subjects had an average of 6.69 valid days of accelerometer data, as compared with 6.75 valid days for included control subjects (P = 0.78). Estimated accelerometer wear time over valid days was 15.8 and 15.6 hours for control and glaucoma

Discussion

This report is the first to quantify the impact of glaucomatous VF loss on walking and physical activity performed during the normal lives of patients. The study was designed to investigate if glaucoma subjects with bilateral VF loss engage in less physical activity than a control group consisting of glaucoma suspects with normal visual acuity and VFs. No group differences in MVPA were noted, possibly because glaucoma patients with mild bilateral VF loss had physical activity levels that are

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: Manuscript no. 2011-1431.

: Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

: Supported in part by the Dennis W. Jahnigen Memorial Award, the American Geriatrics Society, New York, NY; the National Institutes of Health, Bethesda, Maryland (grant no.: EY018595); the Robert and Helen Schaub Special Scholar Award, Research to Prevent Blindness, New York, New York; and the Intramural Research Program of the National Institute of Aging, National Institutes of Health. All funding organizations had no role in the design or conduct of this research.

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Original articleReal-World Assessment of Physical Activity in Glaucoma Using an Accelerometer

Objective

Design

Participants

Methods

Main Outcome Measures

Results

Conclusions

Financial Disclosure(s)

Section snippets

Patients and Methods

Results

Discussion

J Clin Epidemiol

J Cataract Refract Surg

J Clin Epidemiol

The number of people with glaucoma worldwide in 2010 and 2020

Br J Ophthalmol

Estimating the rate of progressive visual field damage in those with open-angle glaucoma, from cross-sectional data

Invest Ophthalmol Vis Sci

Glaucoma and disability: which tasks are affected, and at what stage of disease?

Curr Opin Ophthalmol

Evaluation of quality of life and priorities of patients with glaucoma

Invest Ophthalmol Vis Sci

Age-related eye disease and mobility limitations in older adults

Invest Ophthalmol Vis Sci

Glaucoma and mobility performance: the Salisbury Eye Evaluation Project

Ophthalmology

Mobility performance in glaucoma

Invest Ophthalmol Vis Sci

Visual impairment and postural sway among older adults with glaucoma

Optom Vis Sci

Inferior field loss increases rate of falls in older adults with glaucoma

Optom Vis Sci

Risk of falls and motor vehicle collisions in glaucoma

Invest Ophthalmol Vis Sci

Physical Activity Guidelines Advisory Committee Report, 2008

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JAMA

Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus

N Engl J Med

Epidemiology of osteoporosis and osteoporotic fractures

Epidemiol Rev

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Med Sci Sports Exerc

Original article
Real-World Assessment of Physical Activity in Glaucoma Using an Accelerometer