The Association Between Visual Function Deficits and Poor Muscle Health in Multiethnic Older Asians: The Pioneer Study

ABSTRACT Background To determine the associations between deficits in the visual function system, comprising visual acuity (VAI), contrast sensitivity (CSI), colour vision (CVI), depth perception (DPI) and visual field (VFI) impairments, as well as poor muscle health in an older Asian population. Methods We used data from the baseline assessment of the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER; 2017–2022) study. Visual function deficits included near visual acuity impairment (NVAI) (> N8), distance visual acuity impairment–DVAI (< 20/40 or > 0.3 logMAR), CSI (< 1.55 logCS), CVI (1 or more major crossings on Farnsworth D‐15), DPI (≥ 150 arc sec) and VFI (Hodapp, Parish and Anderson criteria). Poor muscle health was defined as the presence of either low muscle mass (appendicular‐lean‐mass/height 2 of < 7 kg/m 2 for males and < 5.4 kg/m 2 for females), or low muscle strength (handgrip strength < 28 kg and < 18 kg, in men and women, respectively) or low physical performance (gait speed of < 1.0 m/s). Regression models were utilized to evaluate the associations between visual deficits and poor muscle health after adjusting for sociodemographic, clinical and lifestyle factors. Results Of the 2199 included participants (1105 Chinese, 580 Malays and 514 Indians; mean age ± SD: 72.9 ± 8.3 years; 54.3% female), 91.7% had poor muscle health. In multivariable analyses, DVAI (odds ratio [OR]: 2.01; 95%CI: 1.19, 3.40), NVAI (OR: 2.48; 95%CI: 1.31, 4.71), CSI (OR: 1.77; 95%CI: 1.18, 2.64) and CVI (OR: 1.95; 95%CI: 1.07, 3.59) were significantly associated with approximately twice the odds of poor muscle health. Moreover, the likelihood of poor muscle health significantly increased with the severity of visual function deficits (all p trend < 0.05). Participants with moderate–severe DVAI, NVAI, CSI and DPI had much higher odds (OR range: 2.24–5.78) of poor muscle health compared to those without these impairments. No associations were found between VFI and poor muscle health. The leading cause of VAI (near or distance) or CSI in those with poor muscle health was cataract (50.5%). Conclusions Older adults with visual function deficits, especially moderate–severe impairment in DVAI, NVAI and CSI, have a much higher likelihood of poor muscle health. Importantly, most cases of VAI or CSI were treatable. These findings support targeted clinic‐based assessment of visual function deficits and interventions (e.g., cataract surgery) as potential strategies for early prevention and management of poor muscle health.