Population-based assessment of visual impairment among ethnic Dai adults in a rural community in China

Multimorbidity patterns and health-related quality of life among community-dwelling older adults: evidence from a rural town in Suzhou, China

PURPOSE

The high prevalence of multimorbidity in aging societies has posed tremendous challenges to the healthcare system. The aim of our study was to comprehensively assess the association of multimorbidity patterns and health-related quality of life (HRQOL) among rural Chinese older adults.

METHODS

This was a cross-sectional study. Data from 4,579 community-dwelling older adults aged 60 years and above was collected by the clinical examination and questionnaire survey. Information on 10 chronic conditions was collected and the 3-Level EQ-5D (EQ-5D-3L) was adopted to measure the HRQOL of older adults. An exploratory factor analysis was performed to determine multimorbidity patterns. Regression models were fitted to explore the associations of multimorbidity patterns with specific health dimensions and overall HRQOL.

RESULTS

A total of 2,503 (54.7%) participants suffered from multimorbidity, and they reported lower HRQOL compared to those without multimorbidity. Three kinds of multimorbidity patterns were identified including cardiovascular-metabolic diseases, psycho-cognitive diseases and organic diseases. The associations between psycho-cognitive diseases/organic diseases and overall HRQOL assessed by EQ-5D-3L index score were found to be significant (β = - 0.097, 95% CI - 0.110, - 0.084; β = - 0.030, 95% CI - 0.038, - 0.021, respectively), and psycho-cognitive diseases affected more health dimensions. The impact of cardiovascular-metabolic diseases on HRQOL was largely non-significant.

CONCLUSION

Multimorbidity was negatively associated with HRQOL among older adults from rural China. The presence of the psycho-cognitive diseases pattern or the organic diseases pattern contributed to worse HRQOL. The remarkable negative impact of psycho-cognitive diseases on HRQOL necessiates more attention and relevant medical assistance to older rural adults.

Epidemiology, health policy and public health implications of visual impairment and age-related eye diseases in mainland China

The prevalence of visual impairment (VI) and age-related eye diseases has increased dramatically with the growing aging population in mainland China. However, there is limited comprehensive evidence on the progress of ophthalmic epidemiological research in mainland China to enhance our awareness of the prevention of eye diseases to inform public health policy. Here, we conducted a literature review of the population-based epidemiology of VI and age-related eye diseases in mainland China from the 1st of January 1946 to the 20th of October 2021. No language restrictions were applied. There was significant demographic and geographic variation in the epidemic of VI and age-related eye diseases. There are several factors known to be correlated to VI and age-related eye diseases, including age, gender, family history, lifestyle, biological factors, and environmental exposures; however, evidence relating to genetic predisposition remains unclear. In addition, posterior segment eye diseases, including age-related macular degeneration and diabetic retinopathy, are amongst the major causes of irreversible visual impairments in the senile Chinese population. There remains a significant prevention gap, with only a few individuals showing awareness and achieving optimal medical care with regards to age-related eye diseases. Multiple challenges and obstacles need to be overcome, including the accelerated aging of the Chinese population, the lack of structured care delivery in many underdeveloped regions, and unequal access to care. Despite the progress to date, there are few well-conducted multi-center population-based studies following a single protocol in mainland China, which findings can hopefully provide valuable cues for governmental decision-making and assist in addressing and halting the incidence of VI and age-related eye diseases in China.

Characteristics and Clinical Outcomes of 295 Patients With Relapsing Polychondritis

OBJECTIVE

This study analyzes the clinical features of Chinese patients with relapsing polychondritis (RP).

METHODS

The clinical data of 295 patients with RP at Beijing Tongren Hospital were retrospectively analyzed.

RESULTS

The mean age of onset was 41.0 ± 15.0 years. The sex ratio was 1:1. Up to 70.5% of the patients had airway involvement during the disease course; among them, the larynx was most commonly affected (82.2%). One-quarter (25.7%) of the patients with laryngeal involvement underwent tracheotomy as a result of progressive dyspnea or acute laryngeal obstruction. Younger age at onset and respiratory symptoms at initial presentation were independent risk factors for tracheotomy in patients with RP with laryngeal involvement. The risk of tracheotomy in patients who presented with respiratory symptoms was 2.35 times higher than that of patients who presented with other symptoms (HR 2.35, 95% CI 1.23-4.50, P = 0.01). The risk of tracheotomy increased by 4.8% for every 1-year decrease in the age at onset (HR 0.95, 95% CI 0.93-0.97, P < 0.001). The incidence of lower respiratory tract infection was much higher in patients with airway involvement than in those without airway involvement. The main cause of death was respiratory failure as a result of airway obstruction.

CONCLUSION

There is a high prevalence of airway involvement in Chinese patients with RP. Laryngeal involvement is associated with a high risk of death. More attention should be paid to patients with RP with laryngeal involvement who are young at disease onset and present with respiratory symptoms.

Prevalence, Risk Factors, and Causes of Visual Impairment in an Elderly Chinese Uygur Population in Southern Xinjiang

Purpose

To investigate the prevalence, risk factors, and major causes of visual impairment (VI) in an elderly Chinese Uygur population in southern Xinjiang.

Methods

This was a population-based cross-sectional study. Participants aged 50 years and older from Haohan Country, Xinjiang Uygur Autonomous Region, were enrolled from August 2018 to December 2018 using cluster sampling. Participants underwent examinations including presenting visual acuity (PVA), pinhole vision, slit-lamp, intraocular pressure, and direct ophthalmoscopy. Participants' education and demographic information was collected by a questionnaire. The prevalence, risk factors, and major causes of vision loss were evaluated.

Results

A total of 1465 participants (85.4% response rate) were enrolled. The mean age of the subjects was 59.1 ± 9.7 years. The prevalence of mild VI, moderate VI, severe VI, and blindness in the better eye was 13.3%, 12.8%, 2.9%, and 3.4%, respectively. The prevalence of low vision and blindness in this study was higher than that in Altay & Tacheng and Changji in northern Xinjiang, lower than that in Luxi, and similar to that in Tibet. The multiple logistic regression analysis showed that age, education level, and body mass index (BMI) were significantly associated with low vision and blindness (P ≤ 0.001, <0.05, 0.002, respectively). The major causes of low vision were cataract (42.6%), refractive error (19.6%), and glaucoma (12.6%), whereas the primary causes of blindness were cataract (34%), glaucoma (34%), and retinitis pigmentosa (10%).

Conclusions

VI is an important public health issue among elderly Uygur individuals in the area, especially for those with low education levels. Cataract is the leading cause of low vision and blindness.

Prevalence and causes of bilateral visual impairment in rural areas of Tianjin, China - The Tianjin Eye Study

PURPOSE

To estimate the prevalence, causes and risk factors of bilateral visual impairment in rural areas of Tianjin, China.

METHODS

A large population-based, cross-sectional study. A stratified random cluster sampling method was used to investigate 12 233 participants in all age groups living in rural Tianjin. Participants completed questionnaires and received professional ophthalmology examinations.

RESULTS

According to World Health Organization best-corrected visual acuity (BCVA) criteria, the crude prevalence of bilateral visual impairment (BCVA < 20/63), bilateral low vision (BCVA < 20/63 to ≥20/400) and bilateral blindness (BCVA < 20/400) was 2.53%, 2.40% and 0.14% (age- and gender-standardized prevalence was 1.86%, 1.76% and 0.11%). The prevalence increased with age and was higher in women than men. The most common causes of bilateral visual impairment in the total population were cataract (48.39%), refractive error/amblyopia (17.74%), age-related macular degeneration (AMD) (10.00%), diabetic retinopathy (5.81%) and glaucoma (3.87%). For participants younger than 50 years, refractive error/amblyopia was the leading cause of low vision and blindness, while cataract was the major cause in the participants over 50. Female gender, older age and self-reported diabetes were associated with increased risks of visual impairment.

CONCLUSION

The age- and gender-standardized prevalence of low vision, especially in the older group (50+), was higher in this study compared with previous studies in China. Refractive error/amblyopia was the leading cause of bilateral visual impairment in younger group, while cataract was the primary cause in the older group. These findings will provide useful information for planning comprehensive eye healthcare programmes in China.

The prevalence and causes of visual impairment among ethnic Tujia adults in a rural community in China

We aimed to investigate the prevalence and causes of visual impairment (VI) in an elderly Tujia ethnic rural population in Southwest China.From June 1 to December 31, 2018, a random cluster sampling survey was conducted among Tujia individuals aged 50 years or older in the rural areas of Qianjiang District County in Chongqing. The sampling design used village-based clusters of approximately equal size (1000 people). The sampling frame was composed of 110 clusters including 26,527 adults aged 50 years or older; 10 clusters (2556 adults) were randomly selected, and 2122 subjects were examined. Ophthalmologic examinations and questionnaires were administered to all the participants. Low vision and blindness were defined using best-corrected visual acuity (BCVA) and presenting visual acuity, according to The World Health Organization standard. The prevalence of VI was estimated, and causes of VI were identified.The participation rate was 83.0%. The prevalence of VI was 15.2% (BCVA 8.0%). In the study population, the prevalence of low vision and blindness increased with age (P < .05) and was higher among those with a low education level (P < .01). The majority of VI was attributed to cataracts (50.0%) and uncorrected refractive error (35.7%). With BCVA, cataract (79.3%) was the most common cause of VI, followed by age-related macular degeneration (10.7%).The main causes of VI in Tujia ethnic were cataracts and refractive errors. Both cataracts and refractive errors are curable eye diseases; thus, local health institutions need to adopt a more active eye care project as a strategy to prevent blindness.

Genetic polymorphisms of pharmacogenomic VIP variants in the Dai population from Yunnan province

Background

Pharmacogenomics plays a crucial role in individualized therapy, but the variant information of pharmacogenomics in the Dai population is limited. We therefore aimed to screen very important pharmacogenetic (VIP) in the Dai population and compared differences between Dai and other 25 populations.

Methods

In this study, we genotyped 73 VIP variants from the PharmGKB and compared genotype distribution of variants in Dai with other 25 populations by χ2 test. To assess the genetic relationship among 26 populations, we performed the structure analysis. In addition, pair‐wise F‐statistics (Fst) was calculated to measure the population differentiation.

Results

We found 12, 10, 13, 17, 11, 39, 46, 46, 45, 43, 49, 46, 46, 46, 49, 45, 41, 42, 48, 53, 45, 50, 50, 51, 47, and 50 significantly different variants in Dai compared with other 25 populations. Genetic structure analysis showed Dai had close relationships with CDX (Chinese Dai in Xishuangbanna), CHB (Han Chinese in Beijing), JPT (Japanese in Tokyo), and KHV (Kinh in Ho Chi Minh City, Vietnam). Moreover, Dai is the most similar to KHV according to Fst analysis.

Conclusions

Our study complement the pharmacogenomics information of Dai population from Yunnan province and provide a theoretical basis for personalized medicine.

Patterns and Risk Factor Profiles of Visual Loss in a Multiethnic Asian Population: The Singapore Epidemiology of Eye Diseases Study

PURPOSE

To describe the pattern and risk factor traits associated with visual loss (defined as either visual impairment [VI] or blindness) in a multiethnic Asian cohort of Malay, Indian, and Chinese individuals living in Singapore.

METHODS

A total of 10 020 participants from the Singapore Epidemiology of Eye Diseases Study were examined between 2004 and 2011. All underwent standardized examinations. VI (visual acuity <20/40 to ≥20/200) and blindness (visual acuity <20/200) were defined based on the US definition, better-seeing eye. Singapore Population Census 2010 was used to calculate age-standardized prevalence. Multiple logistic regression analysis was performed to determine the independent and joint risk factors associated with visual loss.

RESULTS

Malay individuals had higher age-standardized prevalence of best-corrected and presenting VI (5.4% and 19.9%, respectively) than Indian (3.6% and 18.0%) and Chinese individuals (3.3% and 17.2%). Cataract was the main cause for presenting and best-corrected blindness; cataract and diabetic retinopathy were the top causes for best-corrected VI, consistently observed across the 3 ethnic groups. Older age, female sex, lower socioeconomic status, diabetes, systemic comorbidities, and cognitive impairment were independently associated with increased risk of best-corrected visual loss (all P ≤ .027). Individuals aged ≥60 years with diabetes were 12.7 times (95% confidence interval, 8.39-19.23) likely to have best-corrected visual loss, compared with younger, nondiabetic individuals. Lower income and education explained 58.1% and 23.2% of best-corrected visual loss in this population, respectively.

CONCLUSION

In this urban multiethnic Asian population, we identified common traits associated with visual loss across Malay, Indian, and Chinese individuals. These results will be useful for the planning and designing of eye health services and strategies for Asia's rapidly developing populations living in urban communities. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

Trends of Visual Impairment and Blindness in the Singapore Chinese Population over a Decade

We evaluated the prevalence of visual impairment (VI) and blindness among Chinese adults in the Singapore Chinese Eye Study (SCES, 2009-2011), and compared the trends with the Tanjong Pagar Survey, Singapore (TPS), conducted a decade earlier. The SCES comprised of 3,353 Chinese adults aged ≥40 years (response rate, 72.8%). Participants underwent standardized examinations, including measurements of presenting, and best-corrected visual acuity (VA). Bilateral VI (VA < 20/40 to ≥20/200) and blindness (VA < 20/200) were defined based on the United States definition (better-seeing eye). Age-standardized prevalence was calculated using the 2010 Singapore Chinese Population Census. Primary causes and factors associated with VI and blindness were evaluated. In SCES, the age-standardized prevalence of presenting bilateral VI and blindness were 17.7% and 0.6%, respectively; the age-standardised prevalence of best-corrected bilateral VI and blindness were 3.4% and 0.2%, respectively. The previous TPS reported similar rates of best-corrected bilateral VI (3.8%) and blindness (0.3%). In SCES, cataract remains the main cause for both best-corrected bilateral VI (76.0%) and blindness (50.0%). Older age, female, lower income, lower educational level, and smaller housing type were associated with presenting bilateral VI or blindness (all P ≤ 0.025). These findings will be useful for the planning of eye care services and resource allocation.

Prevalence and causes of low vision and blindness in Baotou: A cross-sectional study

The aim of this study was to investigate the prevalence and causes of low vision and blindness in Baotou, Inner Mongolia.A cross-sectional study was carried out. Multistage sampling was used to select samples. The visual acuity was estimated using LogMAR and corrected by pinhole as best-corrected visual acuity.There were 7000 samples selected and 5770 subjects included in this investigation. The overall bilateral prevalence rates of low vision and blindness were 3.66% (95% CI: 3.17-4.14) and 0.99% (95% CI: 0.73-1.24), respectively. The prevalence of bilateral low vision, blindness, and visual impairment increased with age and decreased with education level. The main leading cause of low vision and blindness was cataract. Diabetic retinopathy and age-related macular degeneration were found to be the second leading causes of blindness in Baotou.The low vision and blindness were more prevalent in elderly people and subjects with low education level in Baotou. Cataract was the main cause for visual impairment and more attention should be paid to fundus diseases. In order to prevent blindness, much more eye care programs should be established.