Visual acuity change and mortality in older adults

Ellen E. Freeman, Brian L. Egleston, Sheila K West, Karen J Bandeen Roche, Gary Rubin

Research output: Contribution to journalArticle

Abstract

PURPOSE. Several studies indicate an increased mortality rate in older adults who have visual impairment, but few have attempted to address a potential causal mechanism. The goals of this study are to determine whether visual acuity loss increases the risk of dying and to examine whether depressive symptoms act as a mediator in this relationship. METHODS. Data were derived from the 2520 older adults who participated in the Salisbury Eye Evaluation project, a population-based prospective 8-year cohort study. Presenting binocular visual acuity was measured with the Early Treatment Diabetic Retinopathy Study [ETDRS] eye chart and depressive symptoms with the General Health Questionnaire Part D subscale. Mortality data were collected by staff follow-up. Analyses were performed with the Cox proportional hazards regression. RESULTS. Worse baseline acuity was associated with a higher mortality rate (hazard ratio [HR] = 1.05; 95% confidence interval [CI], 1.01-1.09). Also, those who gained two or more lines of visual acuity over 2 years had a lower adjusted risk of dying (HR = 0.47; 95% CI, 0.23-0.95). An interaction was detected, in that women who lost S 3 lines of visual acuity over a 2-year period had a higher adjusted risk of dying (HR = 3.97; 95% CI, 2.21-7.15), whereas men did not (HR = 1.32; 95% CI, 0.66-2.63). Depressive symptoms did not mediate these relationships. CONCLUSIONS. If the relationship between visual acuity and mortality is indeed causal, it most likely acts via numerous pathways through a variety of intervening variables. The identification of these intervening variables could give additional targets for intervention if acuity cannot be restored.

Original languageEnglish (US)
Pages (from-to)4040-4045
Number of pages6
JournalInvestigative Ophthalmology and Visual Science
Volume46
Issue number11
DOIs
StatePublished - Nov 2005

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Visual Acuity
Mortality
Confidence Intervals
Depression
Vision Disorders
Diabetic Retinopathy
Cohort Studies
Health
Population
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Visual acuity change and mortality in older adults. / Freeman, Ellen E.; Egleston, Brian L.; West, Sheila K; Bandeen Roche, Karen J; Rubin, Gary.

In: Investigative Ophthalmology and Visual Science, Vol. 46, No. 11, 11.2005, p. 4040-4045.

Research output: Contribution to journalArticle

Freeman, Ellen E. ; Egleston, Brian L. ; West, Sheila K ; Bandeen Roche, Karen J ; Rubin, Gary. / Visual acuity change and mortality in older adults. In: Investigative Ophthalmology and Visual Science. 2005 ; Vol. 46, No. 11. pp. 4040-4045.
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