Purpose : With increased longevity, loss of autonomy in the elderly has become a major challenge in our societies. The objective of this study is to describe the associations of advanced AMD with risk of disability and being bed or homebound, in French older individuals. Methods : The Alienor-3C study is a prospective population-based cohort of residents of Bordeaux, France, who were 73 years or older at baseline (2006-2008). Participants were followed every 2-3 years until 2018. Advanced AMD (neovascular and/or atrophic) was diagnosed at each visit using multimodal imaging. Visual impairment (VI) was defined as best-corrected visual acuity lower than 70 ETDRS letters in the better eye. We analyzed advanced AMD with or without VI, by comparison with none or early AMD. Disability was assessed through questionnaires administered at home, using the Lawton scale for instrumental activities of daily living (IADL) (difficulties in shopping, using transportation, using the telephone, managing medications…) and the Katz scale for basic ADL (difficulties in bathing, dressing, eating…). Being bed or home bound was also evaluated. Associations of AMD with occurrence of disability outcomes were assessed using Cox modelling, with AMD as a time-dependent variable, and adjustment for potential confounders. Results : Overall, 878 participants were followed for 6.9 years on average (standard deviation (SD) 3.5 years). At baseline, mean age of participants was 80.1 years (SD 4.4 years) and 62.4% were women. A total of 113 cases of advanced AMD (12.9%) were diagnosed during the study. In the fully adjusted multivariate model, advanced AMD with VI was significantly associated with the risk of IADL-disability (Hazard Ratio (HR)=3.81, 95% confidence interval (CI): 2.10-6.90), ADL-disability (HR=2.32, 95% CI: 1.34-4.02) and being bed or homebound (HR=2.51, 95% CI: 1.49-4.20), while advanced AMD without VI was not (HR=1.32, 95% CI: 0.80-2.17; HR=1.51, 95% CI: 0.79-2.89; HR=1.40, 95% CI: 0.79-2.50, respectively). Conclusions : This study highlights the major burden of advanced AMD in terms of loss of autonomy, with potential considerable personal, familial and societal consequences. This burden is logically restricted to those with visual impairment, underlining the importance of preventing visual loss in advanced AMD. This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.< Réduire