OBJECTIVE: To assess the association between mortality and cause-specific visual impairment in older people. METHODS: Visual acuity and causes of visual impairment were collected in 13 569 participants 75 years and older participating in a randomized trial of health screening. Participants were followed up for mortality for a median of 6.1 years. RESULTS: Compared with those with 6/6 (or 20/20 Snellen) or better visual acuity, the age- and sex-adjusted rate ratio for visually impaired people (binocular visual acuity <6/18 or <20/60 Snellen) was 1.60 (95% confidence interval, 1.47-1.74), which was markedly attenuated (rate ratio, 1.17; 95% confidence interval, 1.07-1.27) after adjustment for confounding factors. People whose visual impairment was due to cataract or age-related macular degeneration had excess risks of all-cause and cardiovascular mortality, which disappeared after adjustment. People with refractive error remained at small risk, despite adjustment, probably owing to residual confounding from factors associated with minimal use of eye services rather than underlying eye disease. There were no associations with cancer mortality. CONCLUSION: Associations reported for visual impairment and mortality or for specific causes of visual impairment reflect confounding by comorbidities, risk factors, and other factors related to susceptibility to death rather than an independent biological association of vision problems or specific eye diseases.
OBJECTIVE: To assess the association between mortality and cause-specific visual impairment in older people. METHODS: Visual acuity and causes of visual impairment were collected in 13 569 participants 75 years and older participating in a randomized trial of health screening. Participants were followed up for mortality for a median of 6.1 years. RESULTS: Compared with those with 6/6 (or 20/20 Snellen) or better visual acuity, the age- and sex-adjusted rate ratio for visually impaired people (binocular visual acuity <6/18 or <20/60 Snellen) was 1.60 (95% confidence interval, 1.47-1.74), which was markedly attenuated (rate ratio, 1.17; 95% confidence interval, 1.07-1.27) after adjustment for confounding factors. People whose visual impairment was due to cataract or age-related macular degeneration had excess risks of all-cause and cardiovascular mortality, which disappeared after adjustment. People with refractive error remained at small risk, despite adjustment, probably owing to residual confounding from factors associated with minimal use of eye services rather than underlying eye disease. There were no associations with cancer mortality. CONCLUSION: Associations reported for visual impairment and mortality or for specific causes of visual impairment reflect confounding by comorbidities, risk factors, and other factors related to susceptibility to death rather than an independent biological association of vision problems or specific eye diseases.
Authors: Diana Fisher; Chuan-Ming Li; May S Chiu; Christa L Themann; Hannes Petersen; Friðbert Jónasson; Pálmi V Jónsson; Johanna Eyrun Sverrisdottir; Melissa Garcia; Tamara B Harris; Lenore J Launer; Gudny Eiriksdottir; Vilmundur Gudnason; Howard J Hoffman; Mary Frances Cotch Journal: Age Ageing Date: 2013-08-30 Impact factor: 10.668
Authors: David B Rein; John S Wittenborn; Xinzhi Zhang; Benjamin A Allaire; Michael S Song; Ronald Klein; Jinan B Saaddine Journal: Health Serv Res Date: 2011-04-14 Impact factor: 3.402
Authors: M B McGuinness; R P Finger; A Karahalios; R H Guymer; D R English; E W Chong; A M Hodge; L D Robman; G G Giles; J A Simpson Journal: Eye (Lond) Date: 2017-08-18 Impact factor: 3.775
Authors: Saumya M Shah; Matthew R Starr; Lauren A Dalvin; Nneka I Comfere; Jackson E AbouChehade; David O Hodge; Raymond Iezzi; Sophie J Bakri Journal: Retina Date: 2020-05 Impact factor: 4.256
Authors: Christopher G Owen; Zakariya Jarrar; Richard Wormald; Derek G Cook; Astrid E Fletcher; Alicja R Rudnicka Journal: Br J Ophthalmol Date: 2012-02-13 Impact factor: 4.638