Glaucoma and mobility performance - The Salisbury Eye Evaluation Project

Objective: To determine the impact of glaucoma on mobility in a population-based cohort. Design: Population-based observational study. Participants: Persons examined as part of a population-based eye disease study. Methods: Subjects performed a series of tasks, including walking an obstacle course, climbing stairs, performing tandem stands, and walking a 4-meter course. Persons with glaucoma were compared with those without glaucoma to identify differences in mobility. Main Outcome Measures: Speed to complete an obstacle course, number of bumps, ability to perform tandem stands, and walking and stair climbing speed. Results: One thousand two hundred fifty subjects participated in the study. In an analysis adjusting for age, race, and gender, walking speed through the obstacle course was 2.4 m/minute slower for persons with bilateral glaucoma, and these individuals experienced 1.65 times the number of bumps when compared with persons without glaucoma (P<0.05 for both). None of the associations was statistically significant comparing persons with unilateral glaucoma with normals. This association remained after adjusting for other potentially confounding factors including visual acuity (VA), body mass index, height, Mini-Mental State Examination score, grip strength, arthritis, depressive symptoms, comorbidities, and use of mobility aids. Additional analyses indicate that visual field loss drives this association. Conclusions: Bilateral glaucoma reduces mobility performance as measured in multiple ways in this population-based study of community-dwelling individuals. Persons with bilateral glaucoma completed the walking course more slowly and had more bumps even after adjusting for use of a mobility aid, comorbidities, and VA. After adjusting for all other factors, persons with bilateral glaucoma walked on average 2.4 m less per minute through the course than those without glaucoma.