Step Count

While aging is an unavoidable fact of life, the choice to exercise – be that walking, running, or going to the gym – is still widely available to senior citizens of the Western world. But age-associated vision loss can restrict this choice. A new study from the Wilmer Eye Institute at Johns Hopkins University School of Medicine, published in Ophthalmology Science, has sought to delve deeper into how visual impairment (VI) in the elderly impacts their engagement in physical activity..

The researchers took information from 723 individuals – 30 percent who had an objective vision impairment – providing each participant with an accelerometer watch to measure their physical activity. The study found that while their bouts of physical activity remained as frequent as those without sight issues, the participants with VI tended to have “greater activity fragmentation,” i.e., they spent less overall time engaged in their respective physical activity as their sighted counterparts. 

“Unfortunately, we don’t know the precise reason for this association,” says Pradeep Ramulu, Director of the Wilmer Eye Institute’s glaucoma division. “Greater fragmentation may mean that individuals fatigue more easily, or that they choose to do activity in shorter segments for other reasons (visual difficulty, fear of falling, etc). In addition, restricted mobility and impaired driving ability may limit their ability to leave their homes, thereby reducing opportunities for prolonged physical activity.” 

Louay Almidani, post-doctoral researcher at the Wilmer Eye Institute and one of the study’s authors, explains: “Implementing interventions and promoting physical activity, perhaps with an emphasis on increasing the length of activity bouts, may play a beneficial role in preventing negative health outcomes among visually impaired adults.”

“Future longitudinal studies and clinical trials should incorporate objective measures of physical activity to investigate the effectiveness of environmental or behavioral interventions in safely improving mobility and reducing physical activity restriction,” adds Ramulu. “It is possible that wearable technologies could even be used to characterize the trajectory of disease (or its impact),” he says. 

Given that vision impairment has wider-reaching health implications beyond ophthalmology, “detecting and intervening early in cases of vision impairment is crucial, as most instances can be prevented or treated,” says Almidani. “Comprehensive access to eye care, along with public education and policy initiatives, can collectively address the burden of vision impairment and its impact on physical function. This approach has the potential to reduce the risk of negative health outcomes associated with reduced activity.”