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Leveziel N, Marillet S, Braithwaite T, Peto T, Ingrand P, Pardhan S, Bron AM, Jonas JB, Resnikoff S, Julie Anne L, Davis AC, McMahon CM, Bourne RRA. Self-reported dual sensory impairment and related factors: a European population-based cross-sectional survey. Br J Ophthalmol 2024; 108:484-492. [PMID: 36759151 PMCID: PMC10894815 DOI: 10.1136/bjo-2022-321439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/11/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Data on population-based self-reported dual vision and hearing impairment are sparse in Europe. We aimed to investigate self-reported dual sensory impairment (DSI) in European population. METHODS A standardised questionnaire was used to collect medical and socio-economic data among individuals aged 15 years or more in 29 European countries. Individuals living in collective households or in institutions were excluded from the survey. RESULTS Among 296 677 individuals, the survey included 153 866 respondents aged 50 years old or more. The crude prevalence of DSI was of 7.54% (7.36-7.72). Among individuals aged 60 or more, 9.23% of men and 10.94% of women had DSI. Eastern and southern countries had a higher prevalence of DSI. Multivariable analyses showed that social isolation and poor self-rated health status were associated with DSI with ORs of 2.01 (1.77-2.29) and 2.33 (2.15-2.52), while higher income was associated with lower risk of DSI (OR of 0.83 (0.78-0.89). Considering country-level socioeconomic factors, Human Development Index explained almost 38% of the variance of age-adjusted prevalence of DSI. CONCLUSION There are important differences in terms of prevalence of DSI in Europe, depending on socioeconomic and medical factors. Prevention of DSI does represent an important challenge for maintaining quality of life in elderly population.
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Affiliation(s)
| | - Simon Marillet
- Public Health department, CHU Poitiers, Poitiers, France
| | - Tasanee Braithwaite
- School of Immunology and Microbiology and School of Life Course Sciences, Kings College, London, UK
- The Medical Eye Unit, Guy's and St Thomas' Hospital, London, UK
| | - Tunde Peto
- Centre for Public Health, Faculty of Medicine Health and Life Sciences, Queen's University Belfast, Belfast, Belfast, UK
| | - Pierre Ingrand
- Public health department, University of Poitiers, Poitiers, France
| | - Shahina Pardhan
- Vision and Eye Research Institute (VERI), School of Medicine, Anglia Ruskin University, Cambridge, Cambridgeshire, UK
| | - Alain M Bron
- Ophthalmology, University Hospital Centre Dijon Bourgogne, Dijon, Bourgogne-Franche-Comté, France
| | - Jost B Jonas
- Ophthalmology, Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Baden-Württemberg, Germany
| | - Serge Resnikoff
- Brien Holden Vision Institute and SOVS, University of New South Wales, Sydney, New South Wales, Australia
| | - Little Julie Anne
- Centre for Optometry and Vision Science, School of Biomedical Sciences, Biomedical Sciences Research Institute, Ulster University, Coleraine, Belfast, UK
| | | | - Catherine M McMahon
- Hear Center, Macquarie University Faculty of Medicine and Health Sciences, Sydney, New South Wales, Australia
| | - Rupert R A Bourne
- Vision and Eye Research Unit, Anglia Ruskin University Faculty of Science and Technology, Chelmsford, Essex, UK
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Merten N, Schultz AA, Walsh MC, van Landingham SW, Peppard PE, Ryff CDS, Malecki KC. Psychological distress and well-being among sensory impaired individuals during COVID-19 lockdown measures. Ann Epidemiol 2023; 79:19-23. [PMID: 36639063 PMCID: PMC9829601 DOI: 10.1016/j.annepidem.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
PURPOSE Hearing and vision impairment are prevalent chronic conditions associated with poorer mental health. Limitations of in-person contacts during COVID-19-related lockdown measures may affect those with sensory impairments more severely exacerbating mental health problems. We aimed to determine whether hearing and/or visual impairment were associated with more psychological distress during a time of lockdown measures in Spring/Summer 2020 in Wisconsin. METHODS We included 1341(64% women, aged 20-92 years) Survey of the Health of Wisconsin COVID-19 survey participants (May 2020-July,2020). We assessed self-reported current mental health and well-being and vision and hearing impairment. Logistic regression models with sensory impairments as determinants and mental health outcomes were adjusted for age, gender, race, education, heart disease, hypertension, hyperlipidemia, and diabetes. RESULTS Vision impairment was associated with increased odds of generalized anxiety disorder (odds ratio = 2.10; 95% confidence interval = 1.32-3.29) and depressive symptoms (2.57;1.58-4.11), greater likelihood to report loneliness (1.65;1.00-2.64) and hopelessness (1.45;1.01-2.08). Hearing impaired individuals reported more loneliness (1.80;1.05-2.98) and hopelessness (1.42;0.99-2.03). Exploratory analyses revealed that sensory impaired individuals less often chose walking as a coping strategy during the pandemic. CONCLUSIONS Individuals with sensory impairment may represent a particularly vulnerable population during the COVID-19 pandemic. Future research should determine underlying reasons and interventions to mitigate this populations' disadvantages.
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Affiliation(s)
- Natascha Merten
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.
| | - Amy A Schultz
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Matthew C Walsh
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Suzanne W van Landingham
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Paul E Peppard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Carol D S Ryff
- Institute on Aging/Psychology, University of Wisconsin-Madison, Madison, WI
| | - Kristen C Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
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Yan X, Yao B, Chen X, Bo S, Qin X, Yan H. Health insurance enrollment and vision health in rural China: an epidemiological survey. BMC Health Serv Res 2021; 21:761. [PMID: 34332583 PMCID: PMC8325859 DOI: 10.1186/s12913-021-06754-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Vision health is an important aspect of health worldwide. Visual impairment (VI) is associated with poor quality of life and is usually more prevalent in rural areas. To help rural populations obtain vision care, health insurance policies have emerged throughout the world. However, some existing literatures show that health insurance enrollment’s impact on the overall physical health of rural population has been minimal. Focusing on vision health among adults in rural China, our study aims to investigates the impact of health insurance on vision health, heterogeneity of the effect, and the moderating effect of health insurance enrollment on the impact of chronic physical diseases and basic eye diseases on vision health. Methods Primary data were collected through a nation-wide epidemiological survey of vision health conducted in rural China in 2018, with a sample size of 28,787 used in our statistical analysis. Instrumental variables regression and Heckman selection models were conducted to examine the impact of health insurance enrollment and reimbursement ratio adults’ vision health outcomes. Subsample regressions by sex, age, education level, and whether with eye diseases were further conducted to explore the heterogeneity in our results. We then examined whether health insurance enrollment moderates the impact of chronic physical diseases and basic eye diseases on vision health through the method of introducing interaction terms. Results Participating in health insurance reduced the probability of VI by 2.15 %. The reimbursement rate increasing by 1 % point may reduce the probability of worsening VI by 6.12 %. Men (-0.0235, P = 0.0002) benefit more from insurance enrollment than women (-0.0201, P = 0.0082) with respect to vision health. From the young adult group to the oldest group, the marginal effect of health insurance increased from − 0.0068 (P = 0.0394) to -0.0753 (P < 0.0001). The marginal effect on VI was most significant in people with lower education levels and weakened with increased education levels. People with basic eye diseases (-0.0496, P = 0.0033) benefit more from participating insurance than the people without basic eye diseases (-0.0196, P = 0.0001) with respect to vision health. The moderating effects of health insurance enrollment on the impacts of cerebral infarction (-0.1225, P < 0.0001), diabetes (-0.0398, P = 0.0245), hyperlipidemia (-0.1364, P = 0.0271), mental illness (-0.1873, P = 0.0010), glaucoma (-0.1369, P = 0.0073), diabetic retinopathy (-0.1560, P = 0.0043), and retinal vein obstruction (-0.2018, P = 0.0155) on vision health were significantly negative. Conclusions The results suggest that participation in health insurance and higher health insurance reimbursement ratios reduced the risk of VI in the sampled adults. Health insurance has the most significant effect in in vulnerable groups. Heath insurance enrollment moderates the impacts of several chronic physical and basic eye conditions on vision health. Our findings have potential implications for reforming health insurance policies to improve vision health conditions in rural areas of developing countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06754-0.
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Affiliation(s)
- Xiaochang Yan
- National School of Development, Peking University, 100871, Beijing, China
| | - Baoqun Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, 300052, Tianjin, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, 300070, Tianjin, China
| | - Shaoye Bo
- China Foundation for Disabled Persons, Dongcheng District, 100006, Beijing, China
| | - Xuezheng Qin
- School of Economics, Peking University, 100871, Beijing, China. .,Institute for Global Health and Development, Peking University, Beijing, China.
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, 300052, Tianjin, China.
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Vukša D, Stamenković D, Djokić O, Živković M, Mirković J, Zlatanović M, Jakšić V. VISUAL FUNCTION AND QUALITY OF LIFE IN PSEUDOPHAKIC PATIENT S. ACTA MEDICA MEDIANAE 2018. [DOI: 10.5633/amm.2018.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Chandrasekaran N, Harlow S, Moroi S, Musch D, Peng Q, Karvonen-Gutierrez C. Visual impairment at baseline is associated with future poor physical functioning among middle-aged women: The Study of Women's Health Across the Nation, Michigan Site. Maturitas 2016; 96:33-38. [PMID: 28041592 DOI: 10.1016/j.maturitas.2016.11.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/28/2016] [Accepted: 11/14/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Emerging evidence suggests that the prevalence rates of poor functioning and of disability are increasing among middle-aged individuals. Visual impairment is associated with poor functioning among older adults but little is known about the impact of vision on functioning during midlife. The objective of this study was to assess the impact of visual impairment on future physical functioning among middle-aged women. STUDY DESIGN In this longitudinal study, the sample consisted of 483 women aged 42 to 56 years, from the Michigan site of the Study of Women's Health Across the Nation. MAIN OUTCOME MEASURES At baseline, distance and near vision were measured using a Titmus vision screener. Visual impairment was defined as visual acuity worse than 20/40. Physical functioning was measured up to 10 years later using performance-based measures, including a 40-foot timed walk, timed stair climb and forward reach. RESULTS Women with impaired distance vision at baseline had 2.81 centimeters less forward reach distance (95% confidence interval (CI): -4.19, -1.42) and 4.26s longer stair climb time (95% CI: 2.73, 5.79) at follow-up than women without impaired distance vision. Women with impaired near vision also had less forward reach distance (2.26 centimeters, 95% CI: -3.30, -1.21) than those without impaired near vision. CONCLUSION Among middle-aged women, visual impairment is a marker of poor physical functioning. Routine eye testing and vision correction may help improve physical functioning among midlife individuals.
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Affiliation(s)
- Navasuja Chandrasekaran
- University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA; University of Michigan Health System, Department of Ophthalmology, 1000 Wall Street, Ann Arbor, MI 48105, USA
| | - Sioban Harlow
- University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Sayoko Moroi
- University of Michigan Health System, Department of Ophthalmology, 1000 Wall Street, Ann Arbor, MI 48105, USA
| | - David Musch
- University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA; University of Michigan Health System, Department of Ophthalmology, 1000 Wall Street, Ann Arbor, MI 48105, USA
| | - Qing Peng
- University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Carrie Karvonen-Gutierrez
- University of Michigan, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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Lee DJ, Gómez-Marín O, Lam BL, Zheng DD, Arheart KL, Christ SL, Caban AJ. Severity of Concurrent Visual and Hearing Impairment and Mortality. J Aging Health 2016; 19:382-96. [PMID: 17496240 DOI: 10.1177/0898264307300174] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: Visual impairment and, to a lesser extent, hearing impairment are independent predictors of reduced survival in selected studies of community-residing adults. To date, the association of severity of concurrent impairment and mortality has not been examined. Method: The National Health Interview Survey is a continuous, multistage, area probability survey of the U.S. civilian noninstitutionalized population. Mortality linkage with the National Death Index of 116,796 adult participants from 1986 to 1994 with complete impairment data was performed through 1997. Results: Findings indicate that moderate to severe concurrent hearing and visual impairment in women is associated with significantly increased risk of mortality. More modest mortality associations are evident for men and for adults with less severe impairments, irrespective of gender. Discussion: Prevention of severe visual and hearing impairment should be a national public health priority, especially given the aging of the U.S. population.
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Affiliation(s)
- David J Lee
- Department of Epidemiology & Public Health, University of Miami School of Medicine, P.O. Box 016069, Miami, FL 33101, USA.
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Thomas BJ, Sanders DS, Oliva MS, Orrs MS, Glick P, Ruit S, Chen W, Luoto J, Tasfaw AK, Tabin GC. Blindness, cataract surgery and mortality in Ethiopia. Br J Ophthalmol 2016; 100:1157-62. [PMID: 27267606 DOI: 10.1136/bjophthalmol-2015-308328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/18/2016] [Indexed: 11/03/2022]
Abstract
PURPOSE To examine the relationships between blindness, the intervention of cataract surgery and all-cause mortality in a rural Ethiopian population. DESIGN Population-based, interventional prospective study. METHODS Community-based detection methods identified blind Ethiopian persons from two selected kebeles in Amhara region, Ethiopia. Data from 1201 blind patients were collected-628 cataract-blind and 573 blind from other conditions. Free cataract surgery was provided for consenting, cataract-blind patients. Follow-up surveys were conducted after 12 months (±1 month)-the main outcome measure for this report is all-cause mortality at 1 year. RESULTS During the follow-up period, 110 persons died from the selected population (mortality 9.2%), which consisted of those cataract-blind patients who received cataract surgery (N=461), cataract-blind patients who did not receive surgery (N=167) and all non-cataract-blind patients (N=573). Of the 461 patients who received cataract surgery, 44 patients died (9.5%). Of the 740 patients who did not receive surgery, 66 died (8.9%)-28 patients from the cohort of cataract-blind patients who did not receive surgery (16.8%) and 38 patients from the cohort of non-cataract blind (6.6%). Subgroup analysis revealed significantly increased odds of mortality for cataract-blind patients over 75 years of age who did not receive surgery and for unmarried patients of all age groups. CONCLUSIONS In this population, mortality risk was significantly elevated for older cataract-blind patients when compared with non-cataract-blind patients-an elevation of risk that was not noted in an age-matched cohort of cataract-blind patients who underwent cataract surgery as early as 1-year follow-up.
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Affiliation(s)
- Benjamin J Thomas
- Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA Himalayan Cataract Project, Waterbury, Vermont, USA
| | - David S Sanders
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Matthew S Oliva
- Himalayan Cataract Project, Waterbury, Vermont, USA Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Mark S Orrs
- Department of Political Science, Lehigh University, Bethlehem, Pennsylvania, USA School of International and Public Affairs, Columbia University, New York, New York, USA
| | | | - Sanduk Ruit
- Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Wei Chen
- Department of Epidemiology, University of Utah Medical Center, Salt Lake City, Utah, USA
| | - Jill Luoto
- RAND Corporation, Arlington, Virginia, USA
| | | | - Geoffrey C Tabin
- Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA Himalayan Cataract Project, Waterbury, Vermont, USA
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Chen Y, Hahn P, Sloan FA. Changes in Visual Function in the Elderly Population in the United States: 1995-2010. Ophthalmic Epidemiol 2016; 23:137-44. [PMID: 27142717 DOI: 10.3109/09286586.2015.1057603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To document recent trends in visual function among the United States population aged 70+ years and investigate how the trends can be explained by inter-temporal changes in: (1) population sociodemographic characteristics, and chronic disease prevalence, including eye diseases (compositional changes); and (2) effects of the above factors on visual function (structural changes). METHODS Data from the 1995 Asset and Health Dynamics among the Oldest Old (AHEAD) and the 2010 Health and Retirement Study (HRS) were merged with Medicare Part B claims in the interview years and the 2 previous years. Decomposition analysis was performed. Respondents from both studies were aged 70+ years. The outcome measure was respondent self-reported visual function on a 6-point scale (from 6 = blind to 1 = excellent). RESULTS Overall, visual function improved from slightly worse than good (3.14) in 1995 to slightly better than good (2.98) in 2010. A decline in adverse effects of aging on vision was found. Among the compositional changes were higher educational attainment leading to improved vision, and higher prevalence of such diseases as diabetes mellitus, which tended to lower visual function. However, compared to compositional changes, structural changes were far more important, including decreased adverse effects of aging, diabetes mellitus (when not controlling for eye diseases), and diagnosed glaucoma. CONCLUSION Although the US population has aged and is expected to age further, visual function improved among elderly persons, especially among persons 80+ years, likely reflecting a favorable role of structural changes identified in this study in mitigating the adverse effect of ongoing aging on vision.
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Affiliation(s)
- Yiqun Chen
- a Department of Economics , Duke University , Durham , NC , USA
| | - Paul Hahn
- b Department of Ophthalmology , Duke University School of Medicine , Durham , NC , USA
| | - Frank A Sloan
- a Department of Economics , Duke University , Durham , NC , USA
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Chou CF, Beckles GLA, Zhang X, Saaddine JB. Association of Socioeconomic Position With Sensory Impairment Among US Working-Aged Adults. Am J Public Health 2015; 105:1262-8. [PMID: 25880957 DOI: 10.2105/ajph.2014.302475] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between socioeconomic position (SEP) and sensory impairment. METHODS We used data from the 2007 to 2010 National Health Interview Surveys (n = 69 845 adults). Multivariable logistic regressions estimated odds ratios (ORs) for associations of educational attainment, occupational class, and poverty-income ratio with impaired vision or hearing. RESULTS Nearly 20% of respondents reported sensory impairment. Each SEP indicator was negatively associated with sensory impairment. Adjusted odds of vision impairment were significantly higher for farm workers (OR = 1.41; 95% confidence interval [CI] = 1.01, 2.02), people with some college (OR = 1.29; 95% CI = 1.16, 1.44) or less than a high school diploma (OR = 1.36; 95% CI = 1.19, 1.55), and people from poor (OR = 1.35; 95% CI = 1.20, 1.52), low-income (OR = 1.28; 95% CI = 1.14, 1.43), or middle-income (OR = 1.19; 95% CI = 1.07, 1.31) families than for the highest-SEP group. Odds of hearing impairment were significantly higher for people with some college or less education than for those with a college degree or more; for service groups, farmers, and blue-collar workers than for white-collar workers; and for people in poor families. CONCLUSIONS More research is needed to understand the SEP-sensory impairment association.
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Affiliation(s)
- Chiu-Fang Chou
- The authors are with the Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Christ SL, Zheng DD, Swenor BK, Lam BL, West SK, Tannenbaum SL, Muñoz BE, Lee DJ. Longitudinal relationships among visual acuity, daily functional status, and mortality: the Salisbury Eye Evaluation Study. JAMA Ophthalmol 2015; 132:1400-6. [PMID: 25144579 DOI: 10.1001/jamaophthalmol.2014.2847] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Determination of the mechanisms by which visual loss increases mortality risk is important for developing interventional strategies. OBJECTIVE To evaluate the direct and indirect effects of loss of visual acuity (VA) on mortality risk through functional status changes among aging adults. DESIGN, SETTING, AND PARTICIPANTS Prospective longitudinal study of a population-based sample of 2520 noninstitutionalized adults aged 65 to 84 years from September 16, 1993, through July 26, 2003, in the greater Salisbury area of Maryland. Participants underwent reassessment 2, 6, and 8 years after baseline. Mortality status was ascertained from linkage with the National Death Index through 2009. EXPOSURES Results of VA testing and self-reported functional status based on activities of daily living (ADL) and instrumental ADL (IADL). MAIN OUTCOMES AND MEASURE Mortality. RESULTS Worse VA levels at baseline were associated with an increased the risk for mortality (hazard ratio [HR], 1.16 [95% CI, 1.04-1.28]; P < .01) through their effect on lower IADL levels at baseline. Declines in VA over time were associated with increased mortality risk (HR, 1.78 [95% CI, 1.27-2.51]; P < .001) by way of decreasing IADL levels over time. Participants experiencing the mean linear decline in VA of 1 letter on the Early Treatment Diabetic Retinopathy Study acuity chart per year are expected to have a 16% increase in mortality risk during the 8-year study exclusively through associated declines in IADL levels. CONCLUSIONS AND RELEVANCE In this longitudinal study of older adults, VA loss adversely affected IADL levels, which subsequently increased the risk for mortality. Prevention of disabling ocular conditions, treatment of correctable visual impairment, and interventions designed to prevent the effect of visual impairment on IADL declines may all reduce mortality risk in aging adults.
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Affiliation(s)
- Sharon L Christ
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indiana2Department of Statistics, Purdue University, West Lafayette, Indiana
| | - D Diane Zheng
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Bonnielin K Swenor
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Byron L Lam
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Sheila K West
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Stacey L Tannenbaum
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Beatriz E Muñoz
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida5Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
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Crews JE, Chou CF, Zhang X, Zack MM, Saaddine JB. Health-related quality of life among people aged ≥65 years with self-reported visual impairment: findings from the 2006-2010 behavioral risk factor surveillance system. Ophthalmic Epidemiol 2014; 21:287-96. [PMID: 24955821 PMCID: PMC4924345 DOI: 10.3109/09286586.2014.926556] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To examine the association between health-related quality of life (HRQoL) and visual impairment among people aged ≥65 years. METHODS We used cross-sectional data from the 2006-2010 Behavioral Risk Factor Surveillance System to examine six HRQoL measures: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, and moderate/severe. We examined the association between self-reported visual impairment and HRQoL using logistic regression accounting for the survey's complex design. RESULTS People with self-reported moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days compared to those reporting a little or no visual impairment. After controlling for all covariates (age, sex, marital status, race/ethnicity, education, income, diabetes, heart disease, stroke, heart attack, body mass index, leisure time activity, smoking, and medical care cost concerns) and comparing to those with no self-reported visual impairment, people reporting a little visual impairment were more likely to have fair/poor health (odds ratio, OR, 1.2, 95% confidence interval, CI, 1.1-1.3), life dissatisfaction (OR 1.6, 95% CI 1.3-2.0), and disability (OR 1.5, 95% CI 1.3-1.6), and those with self-reported moderate/severe visual impairment had more fair/poor health (OR 1.8, 95% CI 1.6-2.0), life dissatisfaction (OR 2.3, 95% CI 1.8-2.9), and disability (OR 2.0, 95% CI 1.8-2.2). They also had more frequent physically unhealthy days (OR 1.9, 95% CI 1.7-2.1), mentally unhealthy days (OR 1.8, 95% CI 1.5-2.1), and activity limitations days (OR 1.9, 95% CI 1.6-2.2). CONCLUSION Poor HRQoL is strongly associated with the severity of self-reported visual impairment among people aged ≥65 years.
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Affiliation(s)
- John E Crews
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, GA , USA
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Lee PP, Cunningham WE, Nakazono TT, Hays RD. Associations of eye diseases and symptoms with self-reported physical and mental health. Am J Ophthalmol 2009; 148:804-808.e1. [PMID: 19712923 DOI: 10.1016/j.ajo.2009.06.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2006] [Revised: 06/16/2009] [Accepted: 06/17/2009] [Indexed: 11/18/2022]
Abstract
PURPOSE To study the associations of eye diseases and visual symptoms with the most widely used health-related quality-of-life (HRQOL) generic profile measure. DESIGN HRQOL was assessed using the short form-36 (SF-36) version 1 survey administered to a sample of patients receiving care provided by a physician group practice association. METHODS Eye diseases, ocular symptoms, and general health were assessed in a sample of patients from 48 physician groups. A total of 18,480 surveys were mailed out and 7,093 returned; 5,021 of these had complete data. Multiple linear regression models were used to examine the decrements in self-reported physical and mental health associated with eye diseases and symptoms, including trouble seeing and blurred vision. RESULTS Nine percent of the respondents had cataracts, 2% had age-related macular degeneration, 2% glaucoma, 8% blurred vision, and 13% trouble seeing. Trouble seeing and blurred vision both had statistically unique associations with worse scores on the SF-36 mental health summary score. Only trouble seeing had a significant association with the SF-36 physical health summary score. While these ocular symptoms were significantly associated with SF-36 scores, having an eye disease (cataracts, glaucoma, and macular degeneration) was not, after adjusting for other variables in the model. CONCLUSIONS Our results suggest an important link between visual symptoms and general HRQOL. The study extends the findings of prior research to show that both trouble seeing and blurred vision have independent, measurable associations with HRQOL, while the presence of specific eye diseases may not.
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Affiliation(s)
- Paul P Lee
- RAND, Health Sciences Program, Santa Monica, CA, USA
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Khandekar R, Al Fahdi M, Al Jabri B, Al Harby S, Abdulamgeed T. Visual function and ocular status of children with hearing impairment in Oman: a case series. Indian J Ophthalmol 2009; 57:228-9. [PMID: 19384020 PMCID: PMC2683434 DOI: 10.4103/0301-4738.49400] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Visual functions of children with hearing disability were evaluated in a school of Muscat, Oman in 2006. Two hundred and twenty-three children were tested for near vision, distant vision, contrast sensitivity, color vision, field of vision, motion perception and crowding. Profound and severe hearing loss was noted in 161 and 63 students respectively. Thirty-five (81%) students with refractive error were using spectacles. Color vision and field of vision was defective in one student each. In 286 (64.1%) eyes, contrast sensitivity was defective. Abnormal contrast sensitivity was not associated with the severity of hearing loss [RR = 1.04 (95% CI 0.91 to 1.29)]. Children with hearing impairment should be assessed for visual functions. Refractive error and defect in contrast sensitivity were unusually high among these children. In addition to visual aids, we recommend environmental changes to improve illumination and contrast to improve the quality of life of such children with double disability.
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Affiliation(s)
- Rajiv Khandekar
- Department of Non-communicable Diseases Control, Directorate General of Health Affairs, Ministry of Health, Oman.
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Lam BL, Christ SL, Lee DJ, Zheng DD, Arheart KL. Reported visual impairment and risk of suicide: the 1986-1996 national health interview surveys. ARCHIVES OF OPHTHALMOLOGY (CHICAGO, ILL. : 1960) 2008; 126:975-80. [PMID: 18625946 PMCID: PMC2630284 DOI: 10.1001/archopht.126.7.975] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To examine the relationship between reported visual impairment and suicide mortality. METHODS From 1986 through 1996, annual cross-sectional multistage area probability surveys of the US civilian noninstitutionalized population living at addressed dwellings were conducted by the National Center for Health Statistics. We performed mortality linkage through 2002 with the National Death Index of 137,479 adults 18 years and older. The relationships between reported visual impairment and suicide were examined using structural equation modeling. RESULTS The mean duration of follow-up was 11.0 years, and 200 suicide deaths were identified. After controlling for survey design, age, sex, race, marital status, number of nonocular health conditions, and self-rated health, the direct effect of visual impairment on death from suicide was elevated but not significant (hazard ratio, 1.50; 95% confidence interval, 0.90-2.49). The approximate indirect effect of visual impairment on death from suicide via poorer self-rated health (1.05; 1.02-1.08) or number of nonocular health conditions (1.12; 1.01-1.24) was significant. The total effect of visual impairment on death from suicide was elevated but not significant (1.64; 0.99-2.72). CONCLUSIONS Visual impairment may be associated with an increased risk of suicide through its effect on poor health. This suggests that improved treatment of visual impairment and factors causing poor health may potentially reduce suicide risk.
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Affiliation(s)
- Byron L Lam
- Bascom Palmer Eye Institute, University ofMiami School of Medicine, Miami, FL 33136, USA.
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Abstract
OBJECTIVE This study considers the relationship between low vision and function, specifically exploring whether vision loss is differentially associated with activities of daily living (ADL) versus instrumental activities of daily living (IADL) disability. METHODS Guided by the World Health Organization's International Classification of Functioning, Disability, and Health framework, multinomial logistic regression analyses were performed for IADL and ADL on a sample of 9,115 adults aged 65 years and above from the 1998 Health and Retirement study. RESULTS The data supports the fact that ADL and IADL disabilities are associated with vision loss, and there is a differential relationship among functions, with IADLs being more challenging and requiring better visual abilities. DISCUSSION The findings provide evidence that ADL and IADLs require different skills and are associated differently depending on numerous variables. As the incidence of people living with vision loss is increasing to epidemic proportions due to an aging population, understanding the relationship between vision and participation in meaningful activities has important implications.
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Affiliation(s)
- Sue Berger
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA.
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Sloan FA, Picone G, Brown DS, Lee PP. Longitudinal analysis of the relationship between regular eye examinations and changes in visual and functional status. J Am Geriatr Soc 2006; 53:1867-74. [PMID: 16274366 DOI: 10.1111/j.1532-5415.2005.53560.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine whether regular eye examinations are associated with a greater or lesser rate of loss of ability to read newsprint, onset of blindness or low vision, or onset of limitations in instrumental activities of daily living (IADLs) and activities of daily living (ADLs). DESIGN A sample of 14,215 Medicare beneficiaries observed between 1994 and 1999 linked to the 1994 and 1999 National Long-Term Care Surveys (NLTCS). Effects of annual examinations were assessed using instrumental variables. SETTING The Medicare-linked NLTCS is representative of U.S. elderly persons from 1994 to 1999. PARTICIPANTS Longitudinal observational study of persons aged 65 and older. MEASUREMENTS Change in self-reported and provider-reported vision and change in functional limitations associated with vision related to the number of years with eye examinations and other factors. RESULTS Persons with more-regular eye examinations between 1994 and 1998 were less likely to have experienced a decline in vision or in functional status between 1994 and 1999. On average, an additional year with an eye examination was associated with a decrease in the probability of becoming unable to read newsprint of 0.12 (P=.03), a lower probability of onset of low vision or blindness of 0.009 (P=.06), and a decrease in the probability that the number of functional limitations increased of 0.13 (P=.002) for IADLs and 0.05 (P=.003) for ADLs. CONCLUSION Elderly persons who have regular eye examinations experience less decline in vision and functional status.
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Affiliation(s)
- Frank A Sloan
- Center for Health Policy, Law, and Management, Terry Sanford Institute of Public Policy, Duke University, Durham, North Carolina 27708, USA.
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Lachinski A, Vingerhoets A, Markuszewska-Proczko M, Stefaniak T. Long-term quality-of-life assessment after laparoscopic and classic cholecystectomy. Surg Endosc 2004; 18:1152-3; author reply 1154-5. [PMID: 15136932 DOI: 10.1007/s00464-003-9261-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2003] [Accepted: 12/09/2003] [Indexed: 10/26/2022]
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Hashimoto H, Nomura K, Yano E. Psychosomatic status affects the relationship between subjective hearing difficulties and the results of audiometry. J Clin Epidemiol 2004; 57:381-5. [PMID: 15135839 DOI: 10.1016/j.jclinepi.2003.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2003] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Subjective hearing difficulties are often used as a surrogate to audiometry in health check-up, although its effectiveness has not been tested in healthy workers. We conducted a study to test the usefulness of self-reported hearing difficulties for screening hearing impairment among healthy workers by comparing the results with those of audiometry. STUDY DESIGN AND SETTING This was a cross-sectional observational study. A sample of 12,495 healthy workers in Japan without excess noise exposure was recruited at regular health check-up. Audiometry was conducted after self-administered questionnaire asking symptoms including hearing difficulties. The results were compared to those of audiometry as the gold standard. RESULTS Overall prevalence of hearing impairment was 4.6% among the population. Subjective hearing difficulties showed 0.21 of sensitivity, 0.95 of specificity, and 0.93 of accordance against audiometry. When limited to those with more than two psychosomatic symptoms, however, the corresponding numbers were 0.43, 0.85, and 0.83. CONCLUSION The assessment of subjective hearing difficulty may not be able to replace audiometry, but may be useful to detect psychosocial problems of hearing in the workplace.
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Affiliation(s)
- Hideki Hashimoto
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi, Tokyo 173-8605, Japan.
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