Gait dysfunction is common in older people with visual impairment and is a major cause of falls. Evaluating changes in gait measures across the spectrum of baseline visual field (VF) damage in glaucoma, researchers recently found that at worse levels, patients with glaucoma demonstrate an exacerbated decline in walking speeds. This finding indicates that mobility speeds decrease faster over time in older adults with glaucoma.
The prospective study included 241 glaucoma patients and suspects who were followed for up to three years. Baseline damage was defined by visual field sensitivity using data that combines results from each eye into a single measure (integrated visual fields [IVF]) and categorized as normal/mild (>28dB), moderate (23dB to 28dB) and severe (<23dB). Each participant walked on an electronic walkway at a normal pace twice each year of follow-up and was evaluated based on longitudinal changes in gait outcomes stratified within each VF severity category and across the range of IVF sensitivity.
When comparing longitudinal gait changes over three years across the spectrum of IVF sensitivity, each 5dB decrease was associated with more rapid declines in stride velocity and cadence. When evaluating gait changes within each glaucoma severity group, shorter stride length was associated with patients with normal/mild, moderate and severe VF damage, while slower stride velocity and cadence were associated with those with severe VF damage.
“The declines in walking speeds from this post-hoc analysis were fairly substantial, suggesting that individuals with VF damage would have their gait declined more rapidly than normally sighted peers,” the study authors concluded.
E JY, Mihailovic A, Garzon C, et al. Association between visual field damage and gait dysfunction in patients with glaucoma. JAMA Ophthalmol. July 22, 2021. [Epub ahead of print].