THE EFFECT OF SARCOPENIC OBESITY AND VISUAL IMPAIRMENT ON BASIC FUNCTIONAL ACTIVITY
Authors: Agarkov N. , Kopylov A. 
Published: September 2024

Age-associated cataracts and diabetic retinopathy in combination with sarcopenic obesity, formed mainly against the background of physical inactivity due to vision deficiency, potentially contribute to a decrease in patients' activity in daily life, but the latter has not been studied practically by special tests taking into account visual impairment.
Objective. Assess the impact of diabetic retinopathy and cataracts on the daily activities of elderly patients with sarcopenic obesity.
Materials and methods. The study involved 128 patients aged 60–74 years with cataracts and sarcopenic obesity and 125 patients of the same age with diabetic retinopathy and sarcopenic obesity. All patients underwent a comprehensive clinical and instrumental ophthalmological examination. The appropriate criteria presented in the clinical guidelines were used in the diagnosis of cataracts and diabetic retinopathy. Sarcopenia was determined by the European Working Group on Sarcopenia in older people scale, supplemented by carpal dynamometry, and obesity was determined by body mass index.
Results. A more significant effect of cataracts combined with sarcopenic obesity, causing complete dependence on others (12,18 scores) in daily life activities, was found than the effect of diabetic retinopathy combined with sarcopenic obesity, causing moderate dependence (10,18 scores) (p<0.01). Patients of the compared groups also have statistically significant differences in all types of activities in everyday life, including leading ones – threading a needle and cutting nails. In particular, restrictions on threading into a needle in patients with cataracts and sarcopenic obesity have 1,84±0,03 scores, which is significantly higher than in patients with diabetic retinopathy and sarcopenic obesity (p 0,01). A similar pattern has been established for nail clipping, the limits for which are 1,75±0,03 and 1,43±0,04 scores, respectively. However, the following ranking places of the considered limitations of activity in everyday life differ statistically significantly, and in the third position in patients with cataracts and sarcopenic obesity is self–writing (1,68±0,04 scores), and in patients with diabetic retinopathy and sarcopenic obesity – reading the text (1,38±0,03 scores) (p<0,01). The fourth rank also differs when in patients with cataracts and sarcopenic obesity it corresponds to reading the text (1,53±0,04 scores), and in patients with diabetic retinopathy and sarcopenic obesity – writing the text (1,32±0,02 scores) (p<0,01). Factor analysis of the effect of cataracts combined with sarcopenic obesity and diabetic retinopathy combined with sarcopenic obesity showed the greatest factor load in both groups on the formation of dependence on others when threading a needle (0,829 and 0,572, respectively) and when performing nail clipping (0,807 and 0,469, respectively), however, the effect of cataracts and sarcopenic obesity on The development of limitations of these types of activities in everyday life is more significant than diabetic retinopathy and sarcopenic obesity.
Conclusion. Among the considered age-associated ophthalmic diseases in the elderly, cataracts combined with sarcopenic obesity significantly limit the activity of patients in everyday life.