title: Visual impairment at baseline is associated with future poor physical functioning among middle-aged women: The Study of Women's Health Across the Nation, Michigan Site.
abstract: OBJECTIVE
  Emerging evidence suggests that the prevalence rates of poor functioning and of disability are increasing among middle-aged individuals. Visual impairment is associated with poor functioning among older adults but little is known about the impact of vision on functioning during midlife. The objective of this study was to assess the impact of visual impairment on future physical functioning among middle-aged women.
  
  
  METHODS
  In this longitudinal study, the sample consisted of 483 women aged 42 to 56 years, from the Michigan site of the Study of Women's Health Across the Nation.
  
  
  METHODS
  At baseline, distance and near vision were measured using a Titmus vision screener. Visual impairment was defined as visual acuity worse than 20/40. Physical functioning was measured up to 10 years later using performance-based measures, including a 40-foot timed walk, timed stair climb and forward reach.
  
  
  RESULTS
  Women with impaired distance vision at baseline had 2.81 centimeters less forward reach distance (95% confidence interval (CI): -4.19, -1.42) and 4.26s longer stair climb time (95% CI: 2.73, 5.79) at follow-up than women without impaired distance vision. Women with impaired near vision also had less forward reach distance (2.26 centimeters, 95% CI: -3.30, -1.21) than those without impaired near vision.
  
  
  CONCLUSIONS
  Among middle-aged women, visual impairment is a marker of poor physical functioning. Routine eye testing and vision correction may help improve physical functioning among midlife individuals.
authors.affiliation: University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA; University of Michigan Health System, Department of Ophthalmology, 1000 Wall Street, Ann Arbor, MI 48105, USA.
authors.forename: Navasuja
authors.initials: N
authors.lastname: Chandrasekaran
authors.affiliation: University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
authors.forename: Sioban
authors.initials: S
authors.lastname: Harlow
authors.affiliation: University of Michigan Health System, Department of Ophthalmology, 1000 Wall Street, Ann Arbor, MI 48105, USA.
authors.forename: Sayoko
authors.initials: S
authors.lastname: Moroi
authors.affiliation: University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA; University of Michigan Health System, Department of Ophthalmology, 1000 Wall Street, Ann Arbor, MI 48105, USA.
authors.forename: David
authors.initials: D
authors.lastname: Musch
authors.affiliation: University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
authors.forename: Qing
authors.initials: Q
authors.lastname: Peng
authors.affiliation: University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA. Electronic address: ckarvone@umich.edu.
authors.forename: Carrie
authors.initials: C
authors.lastname: Karvonen-Gutierrez
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008824:Michigan; D008875:Middle Aged; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity; D000070857:Walk Test; D016138:Walking / Q000502:physiology*; D016387:Women's Health
keywords: Middle-age; Midlife; Physical functioning; Vision; Visual impairment; Women