Interaction Between Visual Acuity and Peripheral Vascular Disease with Balance

OBJECTIVES: To determine whether visual acuity is related to balance in older adults with peripheral vascular disease (PVD) or diabetes mellitus. DESIGN: Cross-sectional analysis. SETTING: Canada. PARTICIPANTS: Community-dwelling adults aged 45 to 85 from the Canadian Longitudinal Study on Aging (N=30,097). MEASUREMENTS: Visual acuity was measured wearing habitual distance correction using the Early Treatment of Diabetic Retinopathy Study chart at a 2-m distance. Poor balance was defined as being unable to stand on 1 leg for at least 60 seconds. PVD and diabetes mellitus were assessed according to self-report of a physician diagnosis. Multiple logistic regression was used. RESULTS: People who reported PVD (n=1,295) were more likely to have worse balance than those who did not (odds ratio (OR)=1.50, 95% confidence interval (CI)=1.29-1.77). In those who did not report PVD (n=26,211), a 1-line worse score on the visual acuity test was associated with 23% higher odds of being unable to stand for at least 60 seconds after adjusting for age, sex, education, province, body mass index, and diabetes mellitus (OR=1.23, 95% CI=1.20-1.26). In those who reported PVD, the odds of being unable to stand was almost double (OR=1.41, 95% CI=1.22-1.62). The interaction between visual acuity and PVD was statistically significant (P=.02). CONCLUSIONS: Visual acuity and PVD interact in their relationship with balance. People with poor vision and PVD may be at an especially high risk of mobility difficulties.