OBJECTIVES: The aim of this analysis was to evaluate the link between visual impairment and diminished activity of daily living. METHODS: A national survey (1999) was conducted on a random, stratified sample of 356,208 French persons living in the community. A subset of 21,760 subjects was selected at random for further research and 16,945 were interviewed. Two years later (2001) the same subjects were interviewed again. Three groups were identified, based upon subject interviews (blind, low vision (LV) and no visual problem (NVP)). Activity of daily living (ADL) was measured by the Katz index. Loss of ADL was defined as a decrease of at least one Katz level. A weighted stepwise logistic regression was used to determine risk factors of ADL loss. RESULTS: ADL was documented 2 years later for 12,310 subjects (72.65%). The 3 major reasons for uncompleted second interviews were a move, death and refusal to answer. The mean age at the second interview was 40.3 years, 52.3% were female and 2.06% experienced ADL loss. Age was strongly associated with ADL loss (p<0.001). Handicaps were also factors: motor function (odds ratio[OR]=2.56), speech (OR=2.46), brain (OR=2.05) and visceral difficulties (OR=1.81). Visual impairment was found to be an independent factor associated with ADL loss, i.e. LV subjects’ chance of ADL loss was 1.89 times greater while the figure for blind subjects was 5.43 (ORs adjusted on age-squared and other handicaps). CONCLUSIONS: For French persons living in the community, LV and blindness are 2 independent risk factors of ADL loss within 2 years. These results suggest that preservation of visual function would contribute to maintenance of ADL.