Exploring visual impairment as a risk factor for developing frailty in older adults: a cohort study from Thailand

Visual impairment (VI) and frailty often coexist in older adults, leading to an increased risk of adverse health outcomes. However, evidence based on objective measurements among adults living in the community remains limited. This study explored the association between VI and frailty progression among older adults. A retrospective cohort study was conducted among people 60 years and older who participated in health screenings at the Primary Care Unit (PCU) at Siriraj Hospital, Thailand between January 2020 and October 2023 and had their baseline assessment performed. VI was defined as having visual acuity worse than 6/12 in the better eye, while frailty status was assessed using the Thai version of the Frail scale. Follow-up data were collected in 2024 through structured telephone interviews. Multivariate ordinal logistic regression was used to examine the association between VI and frailty transition. Among 400 participants (median age 70 years; 76% female), those with VI had significantly higher odds of frailty progression compared with those without VI (adjusted OR 2.98, 95% confidence interval 1.97–4.52; p < 0.001). Participants with VI reported lower quality of life, with slightly higher rates of falls and hospitalizations. These findings indicate that VI independently predicts frailty progression. Early screening and timely ophthalmologic intervention may help delay frailty development and improve health outcomes in older adults.