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. 2023 Jun:250:49-58.
doi: 10.1016/j.ajo.2023.01.017. Epub 2023 Jan 20.

The Impact of Neighborhood Factors on Physical Activity in Older Adults With Visual Impairment

Catalina Garzon  1 , Aleksandra Mihailovic  1 , Jian-Yu E  1 , Sheila K West  1 , Laura N Gitlin  2 , David S Friedman  3 , Pradeep Y Ramulu  4
Affiliations

The Impact of Neighborhood Factors on Physical Activity in Older Adults With Visual Impairment

Catalina Garzon et al. Am J Ophthalmol. 2023 Jun.

Abstract

Purpose: To investigate the associations of neighborhood-level socioeconomic and environmental characteristics with physical activity in persons with glaucoma.

Design: Cross-sectional study (N = 230).

Methods: Home addresses were used to extract neighborhood factors (NFs): Area Deprivation Index, crime rate, and the proportion of racial and ethnic minorities, poverty, college graduates, and park area in their census tract. Participants' average number of daily steps and nonsedentary minutes were collected over 7 days using an accelerometer. Visual field (VF) loss was quantified as integrated VF sensitivity. Multivariable negative binomial regression models and additional models with an interaction term evaluated the effect of NF on physical activity and whether these relationships differed by VF loss severity.

Results: Participants were on average 70.6 years of age, 51.7% were male, and 27.8% were black. A higher Area Deprivation Index or poverty share was associated with fewer NSM (incidence rate ratio [IRR] = 0.96 per 1 Area Deprivation Index decile increment, P = .01; IRR = 0.92 per 10% poverty share increment, P = .02), while higher share of college graduates was associated with greater NSM (IRR = 1.03 per 10% increment; P = .03). Stronger associations were noted between both high crime rate and poverty share with NSM in individuals with severe VF damage as opposed to no/mild VF damage (IRR = 0.44, P = .001; IRR = 0.81, P = .02).

Conclusions: Select NFs (poverty share and crime rate) may disproportionately affect physical activity in patients with severe VF loss. Interventions to overcome activity limitations within the context of poverty and high socioeconomic disadvantage are important for addressing glaucoma-related disability, particularly in those with severe VF loss.

Keywords: Glaucoma; Low-vision; Physical activity; Social determinants of health; Vision rehabilitation.

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Figures

Figure 1.
Figure 1.
Association of neighborhood factors with metrics of physical activity in adjusted models. Incidence rate ratios (IRR) values are derived from separate multivariable models accounting for age, race, gender, comorbidities, polypharmacy, and visual field damage. Unit increments for each exposure are listed next to each factor. Area deprivation Index (ADI).
See this image and copyright information in PMC

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