Ajay Kolli1, Kristian Seiler2, Neil Kamdar3, Lindsey B De Lott4, Mark D Peterson5, Michelle A Meade5, Joshua R Ehrlich6. 1. From the University of Michigan Medical School, University of Michigan (A.K.), Ann Arbor, Michigan; Harvard T.H. Chan School of Public Health, Harvard University (A.K.), Boston, Massachusetts. 2. Institute for Healthcare Policy and Innovation, University of Michigan (K.S., N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), Ann Arbor, Michigan. 3. Institute for Healthcare Policy and Innovation, University of Michigan (K.S., N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), Ann Arbor, Michigan; University of Michigan Center for Disability Health and Wellness (N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), University of Michigan, Ann Arbor, Michigan; Department of Surgery, Michigan Medicine, University of Michigan (N.K.), Ann Arbor, Michigan; Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan (N.K.), Ann Arbor, Michigan. 4. Institute for Healthcare Policy and Innovation, University of Michigan (K.S., N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), Ann Arbor, Michigan; University of Michigan Center for Disability Health and Wellness (N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), University of Michigan, Ann Arbor, Michigan; Department of Ophthalmology & Visual Sciences, Michigan Medicine (L.B.D.L., J.R.E.), Ann Arbor, Michigan. 5. Institute for Healthcare Policy and Innovation, University of Michigan (K.S., N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), Ann Arbor, Michigan; University of Michigan Center for Disability Health and Wellness (N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), University of Michigan, Ann Arbor, Michigan; Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan (M.D.P., M.A.M.), Ann Arbor, Michigan, USA. 6. Institute for Healthcare Policy and Innovation, University of Michigan (K.S., N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), Ann Arbor, Michigan; University of Michigan Center for Disability Health and Wellness (N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), University of Michigan, Ann Arbor, Michigan; Department of Ophthalmology & Visual Sciences, Michigan Medicine (L.B.D.L., J.R.E.), Ann Arbor, Michigan; Institute for Social Research, University of Michigan, Ann Arbor, Michigan. Electronic address: joshre@med.umich.edu.
Abstract
PURPOSE: To compare the incidence and hazard of neuropsychiatric, musculoskeletal, and cardiometabolic conditions among adults with and without vision impairment (VI). DESIGN: Retrospective cohort study. METHODS: The sample comprised enrollees in a large private health insurance provider in the United States, including 24 657 adults aged ≥18 years with VI and age- and sex-matched controls. The exposure variable, VI, was based on low vision and blindness International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM), diagnosis codes. Physician-diagnosed incident neuropsychiatric, musculoskeletal, and cardiometabolic diseases were identified using ICD codes. Separate Cox proportional hazards regression models were used to assess the association of VI with incidence of 30 chronic conditions, adjusting for Elixhauser Comorbidity Index. Analyses were stratified by age 18-64 years and ≥65 years. RESULTS: In individuals with VI aged 18-64 years (n=7478), the adjusted hazard of neuropsychiatric (HR 2.1, 95% CI 1.9, 2.4), musculoskeletal (HR 1.8, 95% CI 1.7, 2.0), and cardiometabolic (HR 1.8, 95% CI 1.7, 2.0) diseases was significantly greater than in matched controls (mean 5.5 years follow-up). Similar associations were seen between patients with VI aged ≥65 years (n=17 179) for neuropsychiatric (HR 2.4, 95% CI 2.1, 2.7), musculoskeletal (HR 1.8, 95% CI 1.6, 1.9), and cardiometabolic (HR 1.7, 95% CI 1.4, 2.0) diseases. VI was associated with a higher hazard of each of the 30 conditions we assessed, with similar results in both age cohorts. CONCLUSION: Across the life span, adults with VI had an approximately 2-fold greater adjusted hazard for common neuropsychiatric, musculoskeletal, and cardiometabolic disorders compared with matched controls without VI.
PURPOSE: To compare the incidence and hazard of neuropsychiatric, musculoskeletal, and cardiometabolic conditions among adults with and without vision impairment (VI). DESIGN: Retrospective cohort study. METHODS: The sample comprised enrollees in a large private health insurance provider in the United States, including 24 657 adults aged ≥18 years with VI and age- and sex-matched controls. The exposure variable, VI, was based on low vision and blindness International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM), diagnosis codes. Physician-diagnosed incident neuropsychiatric, musculoskeletal, and cardiometabolic diseases were identified using ICD codes. Separate Cox proportional hazards regression models were used to assess the association of VI with incidence of 30 chronic conditions, adjusting for Elixhauser Comorbidity Index. Analyses were stratified by age 18-64 years and ≥65 years. RESULTS: In individuals with VI aged 18-64 years (n=7478), the adjusted hazard of neuropsychiatric (HR 2.1, 95% CI 1.9, 2.4), musculoskeletal (HR 1.8, 95% CI 1.7, 2.0), and cardiometabolic (HR 1.8, 95% CI 1.7, 2.0) diseases was significantly greater than in matched controls (mean 5.5 years follow-up). Similar associations were seen between patients with VI aged ≥65 years (n=17 179) for neuropsychiatric (HR 2.4, 95% CI 2.1, 2.7), musculoskeletal (HR 1.8, 95% CI 1.6, 1.9), and cardiometabolic (HR 1.7, 95% CI 1.4, 2.0) diseases. VI was associated with a higher hazard of each of the 30 conditions we assessed, with similar results in both age cohorts. CONCLUSION: Across the life span, adults with VI had an approximately 2-fold greater adjusted hazard for common neuropsychiatric, musculoskeletal, and cardiometabolic disorders compared with matched controls without VI.
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