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Potter T, Almidani L, Diaz M, Varadaraj V, Mihailovic A, Ramulu PY. Concordance between Self-Reported Visual Difficulty and Objective Visual Impairment: The National Health and Aging Trends Study. Ophthalmology 2024:S0161-6420(24)00363-4. [PMID: 38871087 DOI: 10.1016/j.ophtha.2024.06.009] [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: 12/16/2023] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024] Open
Abstract
PURPOSE To examine the performance of self-reported visual difficulty (VD) in predicting objective visual impairment (VI) in older adults and explore factors that influence discordance. DESIGN Cross-sectional analysis of the National Health and Aging Trends Study (2022). METHODS Participants reporting blindness or difficulties with distance or near vision were characterized as having VD. Presenting binocular distance visual acuity (VA), near VA, and contrast sensitivity (CS) were assessed. Objective VI was defined as having VI in distance VA (worse than 20/40), near VA (worse than 20/40), or CS (worse than 1.55 logCS). Receiver operating characteristic analysis was used to compare performance of VD in predicting VI. To investigate factors that influence discordance, we limited our sample to adults with VI and used a multivariable logistic regression model to identify factors associated with not reporting VD. Similar analyses were performed to explore factors associated with reporting VD in adults without VI. MAIN OUTCOME MEASURES Discordance factors. RESULTS Four thousand nine hundred ninety-nine adults were included in the 2022 cohort. Visual difficulty achieved an area under the curve (AUC) of 56.0 (95% confidence interval [CI], 55.2-56.9) in predicting VI, with a sensitivity of 15.8 (95% CI, 14.2-17.5) and specificity of 96.3 (95% CI, 95.5-96.9). Characteristics associated with not reporting VD in adults with VI included female gender (odds ratio [OR], 0.64 [95% CI, 0.42-0.99]), Hispanic ethnicity (OR, 0.49 [95% CI, 0.31-0.78), higher income (≥75 000, OR, 1.99 [95% CI, 1.14-3.45]), ≥4 comorbidities (OR, 0.46 [95% CI, 0.29-0.72]), and depressive symptoms (OR, 0.49 [95% CI, 0.25-0.93]). Factors associated with self-reporting VD in the absence of VI included Hispanic ethnicity (OR, 2.11 [95% CI, 1.15-3.86]), higher income (≥$75 000, OR, 0.27 [95% CI, 0.12-0.63]), and anxiety symptoms (OR, 3.05 [95% CI, 1.56-5.97]). CONCLUSIONS Self-reported VD is a distinct measure assessing disability and has limited ability in predicting objective VI. Caution is advised when using self-reported VD as a surrogate measure for objective VI in epidemiological studies, although it may still be an effective way to capture risk of current or future disability. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
| | - Louay Almidani
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mariah Diaz
- University of Illinois Chicago, Chicago, Illinois
| | - Varshini Varadaraj
- Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing, Baltimore, Maryland
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Pradeep Y Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Huang AR, Cudjoe TKM, Rebok GW, Swenor BK, Deal JA. Hearing and vision impairment and social isolation over 8 years in community-dwelling older adults. BMC Public Health 2024; 24:779. [PMID: 38475742 DOI: 10.1186/s12889-024-17730-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/10/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Little is known about the long-term impact of hearing and vision impairment on social isolation. This study quantifies the association between hearing, vision, and concurrent hearing and vision impairment (dual sensory impairment) and social isolation over 8 years among older adults. METHODS Data were from the National Health and Aging Trends Study (NHATS), a cohort study (2011 - 2019) of U.S. Medicare beneficiaries aged 65 years and older. Social isolation was measured by a binary indicator incorporating four domains: living arrangement, core discussion network size, religious attendance, and social participation. Hearing, vision, and dual sensory impairments were measured by self-report and modeled categorically (no impairment [ref.], hearing impairment only, vision impairment only, dual sensory impairment). Associations between sensory impairments and odds of social isolation over 8 years were assessed using multivariate generalized logistic mixed models and adjusted for demographic and health characteristics. RESULTS Among 5,552 participants, 18.9% self-reported hearing impairment, 4.8% self-reported vision impairment, and 2.3% self-reported dual sensory impairment. Over 8 years, hearing impairment only was associated with 28% greater odds of social isolation. Participants with hearing impairment only were more likely to live alone and have limited social participation. CONCLUSION Greater clinical awareness of hearing impairment as a risk factor for social isolation can increase opportunities to identify and aid older adults who may benefit from resources and interventions to increase social connection and mitigate social isolation.
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Affiliation(s)
- Alison R Huang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21202, USA.
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Thomas K M Cudjoe
- Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bonnielin K Swenor
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Disability Health Research Center, Johns Hopkins Bloomberg University, Baltimore, MD, USA
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21202, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Disability Health Research Center, Johns Hopkins Bloomberg University, Baltimore, MD, USA
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Heinze N, Jones L, Bertiz F, Saunders E, Gomes RSM. How does the UK public think and feel about people with visual impairment: a review of existing evidence. Front Psychol 2024; 15:1359074. [PMID: 38515970 PMCID: PMC10954816 DOI: 10.3389/fpsyg.2024.1359074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Despite legislation to protect people with visual impairment (V.I.) from discrimination in the United Kingdom (UK), the latter continue to experience overt and covert negative behaviours. Perceived discrimination has been associated with an adverse impact on identity, health and well-being, while negative attitudes have been identified as the biggest barrier to participation in everyday life. This article provides a narrative review of existing evidence of how the UK public treats (behaviours), thinks (perceptions) and feels (attitudes) about people with V.I. Despite limitations, the findings suggest that there is a gap between the behaviours reported by people with V.I. and the attitudes expressed by members of the UK public. Social psychological theories are used to explore possible reasons for this gap, and ways in which it may be addressed. As such, the article provides an example of how social psychological theories can be used to address problems in an applied context.
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Affiliation(s)
| | - Lee Jones
- BRAVO VICTOR, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Firuzé Bertiz
- Royal National Institute of Blind People, London, United Kingdom
| | - Emma Saunders
- Royal National Institute of Blind People, London, United Kingdom
| | - Renata S. M. Gomes
- BRAVO VICTOR, London, United Kingdom
- Northern Hub for Veterans and Military Families Research, Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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Heinze N, Jones L. Social functioning in adults with visual impairment from minority ethnic communities in the United Kingdom. Front Public Health 2024; 12:1277472. [PMID: 38362219 PMCID: PMC10867259 DOI: 10.3389/fpubh.2024.1277472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Background Visual impairment (V.I.) has been associated with a negative impact on social functioning, while social support can impact on well-being in those with V.I. Adults from minority ethnic communities (MEC) are projected to make up an increasing proportion of adults living with V.I. in the UK, but limited research has explored their social functioning. This article provides a preliminary insight into social functioning among MEC adults living with V.I. in the UK. Methods The article reports findings from a secondary analysis of V.I. Lives survey data. V.I. Lives was a UK telephone survey, which explored the life experiences of people with V.I. across a wide range of topics including social functioning. This secondary analysis explored social participation, support, isolation, and relationships among a matched control sample of 77 MEC and 77 adults aged 18 and over from White communities (WC). Participants were matched on age, gender, UK region and urban/rural setting. Subgroup analyses were also conducted for the two largest subgroups within the MEC group, Asian (n = 46) and Black participants (n = 22). Results Contact with like-minded people (U = 2174.50, p = 0.003, r = -0.24) and opportunities to take part in more social activities (U = 2253.50, p = 0.007, r = -0.22) was significantly more important to MEC than WC participants. Moreover, MEC participants were significantly less likely to feel supported by friends/family (U = 3522.50, p = 0.017, r = 0.19) and had fewer people they could ask for help (U = 3775.50, p = 0.001, r = 0.26), but there were no significant differences in the perceived impact of V.I. on their friendships/social life and marriage/relationship, their ability to take part in a range of activities, nor their marital status. Asian participants were significantly more likely than Black participants to feel cut off from the people and places around them (U = 655.50, p = 0.042, r = 0.25). Effect sizes were overall small. Although there were no further statistically significant differences between the two groups, Asian participants were also less likely to be able to take part in activities, and more likely to report a negative impact on their social life/friendships and on their marriage/relationship, as well as a smaller social network. Conclusion The findings suggest that V.I. may have had a greater impact on social functioning among Asian participants in this sample, including on experiences of social isolation and participation in social activities. Future research will need to confirm these findings and explore the possible reasons.
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Affiliation(s)
| | - Lee Jones
- BRAVO VICTOR, London, United Kingdom
- UCL, Institute of Ophthalmology, London, United Kingdom
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Negrey JD, Frye BM, Craft S, Register TC, Baxter MG, Jorgensen MJ, Shively CA. Executive function mediates age-related variation in social integration in female vervet monkeys (Chlorocebus sabaeus). GeroScience 2024; 46:841-852. [PMID: 37217631 PMCID: PMC10828467 DOI: 10.1007/s11357-023-00820-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
In humans, social participation and integration wane with advanced age, a pattern hypothesized to stem from cognitive or physical decrements. Similar age-related decreases in social participation have been observed in several nonhuman primate species. Here, we investigated cross-sectional age-related associations between social interactions, activity patterns, and cognitive function in 25 group-living female vervets (a.k.a. African green monkeys, Chlorocebus sabaeus) aged 8-29 years. Time spent in affiliative behavior decreased with age, and time spent alone correspondingly increased. Furthermore, time spent grooming others decreased with age, but the amount of grooming received did not. The number of social partners to whom individuals directed grooming also decreased with age. Grooming patterns mirrored physical activity levels, which also decreased with age. The relationship between age and grooming time was mediated, in part, by cognitive performance. Specifically, executive function significantly mediated age's effect on time spent in grooming interactions. In contrast, we did not find evidence that physical performance mediated age-related variation in social participation. Taken together, our results suggest that aging female vervets were not socially excluded but decreasingly engaged in social behavior, and that cognitive deficits may underlie this relationship.
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Affiliation(s)
- Jacob D Negrey
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA
| | - Brett M Frye
- Department of Biology, Emory and Henry College, Emory, VA, USA
- Wake Forest Alzheimer's Disease Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Internal Medicine/Gerontology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Suzanne Craft
- Wake Forest Alzheimer's Disease Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Internal Medicine/Gerontology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Thomas C Register
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA
- Wake Forest Alzheimer's Disease Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Mark G Baxter
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Matthew J Jorgensen
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA
| | - Carol A Shively
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA.
- Wake Forest Alzheimer's Disease Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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Im JHB, Trope GE, Buys YM, Yan P, Brent MH, Liu SY, Jin YP. Prevalence of self-reported visual impairment among people in Canada with and without diabetes: findings from population-based surveys from 1994 to 2014. CMAJ Open 2023; 11:E1125-E1134. [PMID: 38052477 DOI: 10.9778/cmajo.20220116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Diabetes, a leading cause of visual impairment, is on the rise in Canada. We assessed trends in the prevalence of visual impairment among people in Canada with and without diabetes to inform the development of strategies and policies for the management of visual impairment. METHODS We analyzed self-reported data from respondents aged 45 years and older in 7 cycles of nationwide surveys (National Population Health Survey and Canadian Community Health Survey) from 1994/95 to 2013/14. The age- and sex-standardized prevalence of visual impairment was calculated. We assessed comparisons by levels of education and income, using sex-standardized prevalence owing to sparse data. RESULTS Among people in Canada with diabetes, the age- and sex-standardized prevalence of visual impairment was 7.37% (95% confidence interval [CI] 5.31%-9.43%) in 1994/95 and 1996/97 combined, decreasing to 3.03% (95% CI 2.48%-3.57%) in 2013/14, giving a standardized prevalence ratio of 0.41 (95% CI 0.30-0.56) comparing 2013/14 with 1994/95 and 1996/97 combined. Among people in Canada without diabetes, visual impairment prevalence decreased from 3.72% (95% CI 3.31%-4.14%) in 1994/95 and 1996/97 combined to 1.69% (95% CI 1.52%-1.87%) in 2013/14, with a standardized prevalence ratio of 0.45 (95% CI 0.40-0.52). Decreased sex-standardized prevalence of visual impairment was observed among people with high and low education levels and incomes among those with and without diabetes. INTERPRETATION Visual impairment prevalence was roughly 2 times higher among those with versus without diabetes in all survey years; from 1994 to 2014, visual impairment prevalence decreased among those with and without diabetes irrespective of education and income levels. These results suggest effective collective efforts by clinicians, researchers, the public and government.
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Affiliation(s)
- James H B Im
- Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont
| | - Graham E Trope
- Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont
| | - Yvonne M Buys
- Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont
| | - Peng Yan
- Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont
| | - Michael H Brent
- Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont
| | - Sophia Y Liu
- Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont
| | - Ya-Ping Jin
- Dalla Lana School of Public Health (Im, Jin), and Department of Ophthalmology and Vision Sciences (Trope, Buys, Yan, Brent, Jin), University of Toronto; Kensington Vision and Research Centre (Yan), Toronto, Ont.; Department of Family Medicine, Schulich School of Medicine and Dentistry (Liu), Western University, London, Ont.
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Schulz S, Harzheim L, Hübner C, Lorke M, Jünger S, Woopen C. Patient-centered empirical research on ethically relevant psychosocial and cultural aspects of cochlear, glaucoma and cardiovascular implants - a scoping review. BMC Med Ethics 2023; 24:68. [PMID: 37641094 PMCID: PMC10464431 DOI: 10.1186/s12910-023-00945-6] [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: 03/03/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The significance of medical implants goes beyond technical functioning and reaches into everyday life, with consequences for individuals as well as society. Ethical aspects associated with the everyday use of implants are relevant for individuals' lifeworlds and need to be considered in implant care and in the course of technical developments. METHODS This scoping review aimed to provide a synthesis of the existing evidence regarding ethically relevant psychosocial and cultural aspects in cochlear, glaucoma and cardiovascular implants in patient-centered empirical research. Systematic literature searches were conducted in EBSCOhost, Philpapers, PsycNET, Pubmed, Web of Science and BELIT databases. Eligible studies were articles in German or English language published since 2000 dealing with ethically relevant aspects of cochlear, glaucoma and passive cardiovascular implants based on empirical findings from the perspective of (prospective) implant-wearers and their significant others. Following a descriptive-analytical approach, a data extraction form was developed and relevant data were extracted accordingly. We combined a basic numerical analysis of study characteristics with a thematically organized narrative synthesis of the data. RESULTS Sixty-nine studies were included in the present analysis. Fifty were in the field of cochlear implants, sixteen in the field of passive cardiovascular implants and three in the field of glaucoma implants. Implant-related aspects were mainly found in connection with autonomy, freedom, identity, participation and justice, whereas little to no data was found with regards to ethical principles of privacy, safety or sustainability. CONCLUSIONS Empirical research on ethical aspects of implant use in everyday life is highly relevant, but marked by ambiguity and unclarity in the operationalization of ethical terms and contextualization. A transparent orientation framework for the exploration and acknowledgment of ethical aspects in "lived experiences" may contribute to the improvement of individual care, healthcare programs and research quality in this area. Ethics-sensitive care requires creating awareness for cultural and identity-related issues, promoting health literacy to strengthen patient autonomy as well as adjusting healthcare programs accordingly. More consideration needs to be given to sustainability issues in implant development and care according to an approach of ethics-by-design.
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Affiliation(s)
- Sabine Schulz
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and University Hospital of Cologne, Universitätsstraße 91, 50931, Cologne, Germany.
| | - Laura Harzheim
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and University Hospital of Cologne, Universitätsstraße 91, 50931, Cologne, Germany
| | - Constanze Hübner
- Center for Life Ethics, University of Bonn, 53113, Bonn, Germany
| | - Mariya Lorke
- Faculty of Engineering and Mathematics, University of Applied Sciences and Arts (HSBI), 33619, Bielefeld, Germany
| | - Saskia Jünger
- Department of Community Health, University of Applied Health Sciences Bochum, Gesundheitscampus 6-8, 44801, Bochum, Germany
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Dada T, Chauhan N. Optimizing Glaucoma Care: A Holistic Approach. J Curr Glaucoma Pract 2023; 17:111-112. [PMID: 37920376 PMCID: PMC10618607 DOI: 10.5005/jp-journals-10078-1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
How to cite this article: Dada T, Chauhan N. Optimizing Glaucoma Care: A Holistic Approach. J Curr Glaucoma Pract 2023;17(3):111-112.
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Affiliation(s)
- Tanuj Dada
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Nidhi Chauhan
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Zhang Q, Ju Y, Zheng W, Xie L, Wang X, Ren H, Chen Z, Liu X, Bai X, Fan R. Association of cataract extraction and the risk of dementia-A systematic review and meta-analysis. Front Aging Neurosci 2023; 15:1168449. [PMID: 37304075 PMCID: PMC10248513 DOI: 10.3389/fnagi.2023.1168449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives This research aims to investigate if cataract extraction lowers the risk of all-cause dementia. Methods Original literature on cataract surgery associated with all-cause dementia as of November 27, 2022, was searched in several commonly used databases. Manual review was used to include eligible studies. Stata software (version 16) was used to perform statistical analysis on pertinent data. Publication bias can be precisely evaluated using funnel plots and Egger's test. Results In the meta-analysis of 4 cohort studies with 245,299 participants. Pooled analysis indicated that cataract surgery was linked to a lower incidence of all-cause dementia (OR = 0.77, 95%CI: 0.66-0.89; I2= 54.7%; P < 0.001). Cataract surgery was linked to a lower risk of AD (OR = 0.60, 95%CI: 0.35-1.02; I2= 60.2%; P < 0.001). Conclusions Cataract surgery is linked to a lower incidence of all-cause dementia and Alzheimer's disease. A cataract is a reversible visual impairment. Cataract surgery may be a protective factor against the onset of all-cause dementia and can reduce the economic and family burden caused by all-cause dementia worldwide. Given the restricted pool of included studies, our findings necessitate meticulous interpretation. Systematic review registration http://www.crd.york.ac.uk/prospero retrieve registration details by searching CRD4202379371.
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Affiliation(s)
- Qiao Zhang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Yuan Ju
- Department of Ophthalmology, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Wei Zheng
- Department of Ophthalmology, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Lulu Xie
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Xi Wang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Huanhuan Ren
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Zhipeng Chen
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Xingtong Liu
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Xiaolin Bai
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Ruile Fan
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
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Wang P, Wang Z, Liu X, Zhu Y, Wang J, Liu J. Gender differences in the association between sensory function and CIND among Chinese elderly: Based on CLHLS. Arch Gerontol Geriatr 2023; 113:105054. [PMID: 37210874 DOI: 10.1016/j.archger.2023.105054] [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: 02/27/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To explore the gender differences of the association between sensory impairment (SI) and the risk of cognitive decline and possible cognitive impairment, no dementia (CIND). METHOD Data were drawn from three waves of the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011/12-2018 surveys, involving 6138 participants aged 65 or older who had no CIND at the baseline. Multivariate linear or logistic regression models were employed to examine the effect of SI on cognitive decline and CIND risk by gender stratification, respectively. RESULTS Hearing impairment and visual impairment were associated with lower MMSE scores, and the strength of the association was stronger in men than in women. Hearing impairment was related to an elevated risk of CIND both in men and women (Men: OR=2.46; 95% CI=1.81, 3.35; Women: OR=1.43; 95% CI=1.09, 1.88). However, the effect of visual impairment on CIND was statistically significant only in men (OR=1.43; 95% CI=1.09, 1.88). The risk of cognitive decline and CIND were significantly higher with single and dual SI than those without SI, except for women with single visual impairment. CONCLUSION SI is independently associated with cognitive decline and CIND risk, and the association differed by gender. Further researches should clarify the mechanism between SI and cognitive function among older adults, especially for gender differences.
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Affiliation(s)
- Ping Wang
- Institute of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, 330004, China
| | - Zhixiang Wang
- School of Computer science, Jiangxi Normal University, Nanchang, Jiangxi, 330004, China
| | - Xia Liu
- Institute of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, 330004, China
| | - Yao Zhu
- Institute of Chinese Medicine and Health Development, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, 330004, China
| | - Junyong Wang
- Institute of Chinese Medicine and Health Development, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Jiancheng Liu
- Institute of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, 330004, China.
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Tsai HR, Lo RY, Liang KH, Chen TL, Huang HK, Wang JH, Lee YC. Risk of Subsequent Dementia or Alzheimer Disease Among Patients With Age-Related Macular Degeneration: A Systematic Review and Meta-analysis. Am J Ophthalmol 2023; 247:161-169. [PMID: 36375591 DOI: 10.1016/j.ajo.2022.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE Alzheimer disease (AD), a common form of dementia, shares several clinical and pathologic features with age-related macular degeneration (AMD). Epidemiologic reports on the association of AMD with subsequent dementia or AD are inconsistent. DESIGN Systematic review and meta-analysis. METHODS The Meta-analysis of Observational Studies in Epidemiology reporting guidelines were applied. The Newcastle-Ottawa Scale was used to evaluate the risk of bias in the included cohort studies that examined the association of AMD with subsequent dementia or AD. We estimated the pooled hazard ratios (HRs) of dementia or AD using random effects model meta-analysis and subgroup analysis on different follow-up periods, AMD subtype, gender, age, study design, and methods to ascertain dementia or AD. RESULTS A total of 8 223 581 participants were included in 8 studies published during 2000-2021. The meta-analysis showed that AMD was significantly associated with subsequent dementia (pooled HR 1.22, 95% CI 1.01-1.47) or AD (pooled HR 1.21, 95% CI 1.03-1.43). Our secondary analysis revealed that the association was more noticeable in dry AMD than wet AMD. CONCLUSIONS Patients with AMD have higher risks of developing dementia or AD, and therefore identifying related comorbidities and retinal biomarkers is much warranted for older adults with AMD in ophthalmologic practice.
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Affiliation(s)
- Hou-Ren Tsai
- From the Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (H.-R.T., Y.-C.L.), Hualien
| | - Raymond Y Lo
- Division of Cognitive/Geriatric Neurology, Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University (R.Y.L.), Hualien; Institute of Medical Sciences, Tzu Chi University (R.Y.L.), Hualien
| | - Kai-Hsiang Liang
- Department of Medical Education, Medical Administration Office, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City
| | - Tai-Li Chen
- Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (T.-L.C.), Hualien; Department of Dermatology, Taipei Veterans General Hospital (T.-L.C.), Taipei
| | - Huei-Kai Huang
- Department of Family medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (H.-K.H.), Hualien; Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (H.-K.H., J.-H.W.), Hualien
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (H.-K.H., J.-H.W.), Hualien
| | - Yuan-Chieh Lee
- From the Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (H.-R.T., Y.-C.L.), Hualien; Department of Ophthalmology and Visual Science, Tzu Chi University (Y.-C.L.), Hualien.
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12
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Wändell PE, Ljunggren G, Wahlström L, Carlsson AC. Psychiatric diseases and dementia and their association with open-angle glaucoma in the total population of Stockholm. Ann Med 2022; 54:3349-3356. [PMID: 36411732 PMCID: PMC9704081 DOI: 10.1080/07853890.2022.2148735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Association between some somatic diseases and primary open-angle glaucoma (POAG) are well-known. We aimed to study psychiatric diseases and dementia and their association with POAG in the total population of Region Stockholm. METHODS All living individuals above 18 years of age who resided in Stockholm County, Sweden, on 1 January 2017 (N = 1,703,675) were included. Data were obtained from administrative regional data. We identified individuals with specified psychiatric disorders in the years 2010-2019, and further identified those with an incident diagnosis of POAG during 2012-2018. Analyses were performed by age-group and sex. We calculated odds ratios (ORs) with 95% confidence intervals (95% CI), adjusted for age and neighborhood socio-economic status for individuals with POAG, and used individuals without POAG as referents. RESULTS A total of 16,299 cases of POAG were identified, of whom 9204 were women and 7095 men. Adjusted OR (95% CI) for the risk of POAG was 0.653 (0.610-0.698) for women and 0.714 (0.656-0.778) for men with dementia, respectively. The OR for POAG was 0.478 (0.355-0.643) for women with psychosis, and 1.164 (1.105-1.227) for women with depression. A high neighbourhood socio-economic status was associated with a higher risk of POAG. Other associations were non-significant. CONCLUSION The prevalence of newly diagnosed POAG was decreased in men and women with dementia, and in women with psychosis, which could be an underestimation, owing to lack of investigation, which warrants attention. The risk of POAG was increased in women with depression, which could be secondary to the glaucoma diagnosis.KEY MESSAGESThe prevalence of newly diagnosed glaucoma was decreased in men and women with dementia, and in women with psychosis. A lower prevalence of newly diagnosed glaucoma may be due to an underestimation, owing to a lack of investigation.The risk of glaucoma was increased in women with depression, which could be secondary to the glaucoma diagnosis.
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Affiliation(s)
- Per E Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden
| | - Gunnar Ljunggren
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden.,Academic Primary Health Care Centre, Region Stockholm Region, Stockholm, Sweden
| | - Lars Wahlström
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Axel Carl Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden.,Academic Primary Health Care Centre, Region Stockholm Region, Stockholm, Sweden
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13
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He W, Li P, Gao Y, You J, Chang J, Qu X, Zhang W. Self-reported visual impairment and depression of middle-aged and older adults: The chain-mediating effects of internet use and social participation. Front Public Health 2022; 10:957586. [PMID: 36466466 PMCID: PMC9714326 DOI: 10.3389/fpubh.2022.957586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background Visual impairment (VI) is a strong predictor of depression in middle-aged and older adults. However, the underlying mechanisms and pathways have not been well characterized. The purpose of this study was to determine whether Internet use and social participation mediate the effects of self-reported VI on depression. Methods The study used the fourth wave of cross-sectional data from the China Health and Retirement Longitudinal Study, including 19,766 Chinese adults. Depression was assessed according to the CES-D 10 International Scale. Logistic regression models were used to examine the relationship between self-reported VI and depression. While adjusting for relevant covariates, the PROCESS macro (model nos. 6 and 91) was used to assess the chain-mediating effects of Internet use and social participation. Results A total of 17,433 respondents were included in this study. The CES-D 10 results showed that 7,327 middle-aged and older adults had depressive symptoms, of whom 39.5% were male and 10.2% were ≥75 years old. 32.1% of respondents self-reported VI. Regression analysis showed a positive association between VI and depression, while Internet use and social participation had a negative predictive effect on depression. In the mediation analysis, the social participation pathway contributed the most to the total effect, accounting for 52.69% of it. The proportion of Internet use is 37.72%. When these two mediators were considered together in the full model, they accounted for 9.58% of the total effect of VI on depression. Conclusion Internet use and social participation were important mediators that mitigated the effects of VI on depression. Combined with previous evidence, online activities such as e-health and m-health can effectively promote disease monitoring and diagnosis, and various offline social participation activities can also play a role in regulating emotions. Therefore, Internet use and social participation factors may serve as relevant entry points for the development of intervention programs that may further improve the mental health of the visually impaired.
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Affiliation(s)
- Wenbo He
- Institute of Hospital Management, West China Hospital of Sichuan University, Chengdu, China,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Peiyi Li
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China,Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Center of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China,The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Jiuhong You
- School of Rehabilitation Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Jiangeng Chang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Xing Qu
- Institute of Hospital Management, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu, China,*Correspondence: Wei Zhang
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14
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Association between sensory impairments and restricted social participation in older adults: A cross-sectional study. Collegian 2022. [DOI: 10.1016/j.colegn.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Kolli A, Mozaffarian RS, Kenney EL. Food Insecurity and Vision Impairment Among Adults Age 50 and Older in the United States. Am J Ophthalmol 2022; 236:69-78. [PMID: 34653357 DOI: 10.1016/j.ajo.2021.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To test the hypothesis that food insecurity is associated with greater prevalence of vision impairment (VI). DESIGN Cross-sectional, nationally representative survey of US adults. METHODS Adults 50 years and older were included. Food security category (ie, full, marginal, low, or very low) was assessed by the US Household Food Security Survey Module. Objective presenting VI (PVI) and self-reported VI (SRVI) were assessed by examination and survey, respectively. Separate logistic regression models were constructed with food insecurity category as a predictor of PVI or SRVI. Models were adjusted for age, gender, race, education, income, cigarette use, alcohol use, body mass index, and physical activity. Age-stratified analyses (age 50 through 64 years vs 65 years and older) were also conducted. RESULTS Mean age of participants (n = 10,078) was 63.4 years; 8,518 (89.9%) were fully food secure, 1,033 (7.2%) had PVI, and 2,633 (20.1%) had SRVI. Compared with full food security, adjusting for sociodemographic confounders, those with marginal (adjusted odds ratio [aOR], 1.31; 95% CI, 0.97-1.76), low (aOR, 1.61; 95% CI, 1.17-2.23), and very low (aOR, 2.71; 95% CI, 1.75-4.20) food security had higher odds of PVI. Compared with full food security, those with marginal (aOR, 1.58; 95% CI, 1.23-2.02), low (aOR, 1.46; 95% CI, 1.11-1.92), and very low (aOR, 1.85; 95% CI, 1.41-2.41) food security had higher odds of SRVI. The associations between food insecurity and PVI were greater in magnitude in those 65 years and older compared with those age 50 through 64 years. CONCLUSIONS In this nationally representative sample of US adults 50 years and older, severe food insecurity was increasingly associated with greater prevalence of VI in a dose-response manner.
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Affiliation(s)
- Ajay Kolli
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA; University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA.
| | - Rebecca S Mozaffarian
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Erica L Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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16
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Mathieu R, Hereth E, Lenoble Q, Rouland JF, McKendrick AM, Boucart M. Spatial frequency bands used by patients with glaucoma to recognize facial expressions. VISUAL COGNITION 2022. [DOI: 10.1080/13506285.2022.2044948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rémi Mathieu
- Inserm, CNRS, CHU Lille, UMR-S 1172 - Lille Neuroscience & Cognition, University of Lille, Lille, France
| | - Esther Hereth
- Institute of glaucoma, Saint Joseph Hospital, Paris, France
| | - Quentin Lenoble
- Inserm, CNRS, CHU Lille, UMR-S 1172 - Lille Neuroscience & Cognition, University of Lille, Lille, France
| | - Jean-François Rouland
- Inserm, CNRS, CHU Lille, UMR-S 1172 - Lille Neuroscience & Cognition, University of Lille, Lille, France
| | - Allison M. McKendrick
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Australia
| | - Muriel Boucart
- Inserm, CNRS, CHU Lille, UMR-S 1172 - Lille Neuroscience & Cognition, University of Lille, Lille, France
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17
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Kolli A, Seiler K, Kamdar N, De Lott LB, Peterson MD, Meade MA, Ehrlich JR. Longitudinal Associations Between Vision Impairment and the Incidence of Neuropsychiatric, Musculoskeletal, and Cardiometabolic Chronic Diseases. Am J Ophthalmol 2022; 235:163-171. [PMID: 34543661 PMCID: PMC8863581 DOI: 10.1016/j.ajo.2021.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/07/2021] [Accepted: 09/07/2021] [Indexed: 11/01/2022]
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.
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Affiliation(s)
- Ajay Kolli
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA
| | - Kristian Seiler
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Neil Kamdar
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI,University of Michigan Center for Disability Health and Wellness. University of Michigan, Ann Arbor, MI,Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI,Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Lindsey B. De Lott
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI,University of Michigan Center for Disability Health and Wellness. University of Michigan, Ann Arbor, MI,Department of Ophthalmology & Visual Sciences, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Mark D. Peterson
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI,University of Michigan Center for Disability Health and Wellness. University of Michigan, Ann Arbor, MI,Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Michelle A. Meade
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI,University of Michigan Center for Disability Health and Wellness. University of Michigan, Ann Arbor, MI,Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Joshua R. Ehrlich
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI,University of Michigan Center for Disability Health and Wellness. University of Michigan, Ann Arbor, MI,Department of Ophthalmology & Visual Sciences, Michigan Medicine, Ann Arbor, Michigan, USA,Institute for Social Research, University of Michigan, Ann Arbor, MI USA
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18
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Systemic diseases and their association with open-angle glaucoma in the population of Stockholm. Int Ophthalmol 2021; 42:1481-1489. [PMID: 34845599 PMCID: PMC9122867 DOI: 10.1007/s10792-021-02137-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/12/2021] [Indexed: 11/25/2022]
Abstract
Objective We aimed to study open-angle glaucoma in association with somatic comorbidities in the total population of adults in Region Stockholm. Methods The study population included all living persons aged 19 years and above who resided in Stockholm County, Sweden, on 1 January 2017 (N = 1 703 675). Subjects with specified diseases were identified with data from all registered consultations and hospital stays during 2008–2019. As outcome, the risk of being associated with a diagnosis of open-angle glaucoma was identified during 2012–2018. Analyses were performed by gender, controlling for age and socio-economic status. Age-adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) for women and men with open-angle glaucoma, using individuals without this as referents, were calculated. Socio-economic status was assessed based on the neighbourhood the subjects lived in. Results In total, 16,299 cases of open-angle glaucoma were identified during 2012–2018, 9204 women and 7095 men. Higher fully adjusted OR (95% CI) for risk of being associated with open-angle glaucoma was for women and men with diabetes 1.138 (1.074–1.207) and 1.216 (1.148–1.289), cancer 1.175 (1.120–1.233) and 1.106 (1.048–1.166), hypertension 1.372 (1.306–1.440) and 1.243 (1.179–1.311); and for women with thyroid diseases 1.086 (1.030–1.146), chronic lung diseases 1.153 (1.093–1.216), and inflammatory arthropathies 1.132 (1.006–1.275). Higher glaucoma incidence was observed in individuals residing in high socio-economic status neighbourhoods. Conclusion The risk of glaucoma is increased in some somatic diseases, especially in individuals with diabetes, hypertension and cancer; and in higher socio-economic neighbourhoods as compared to lower socio-economic neighbourhoods. Supplementary Information The online version contains supplementary material available at 10.1007/s10792-021-02137-w.
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19
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Kolli A, Hood MM, Karvonen-Gutierrez C, Moroi SE, Ehrlich JR, Gillespie BW, Dougherty Wood S, Musch DC. Midlife Vision Impairment and Cognitive Function in Later Life: The Study of Women's Health Across the Nation, Michigan Cohort. J Gerontol A Biol Sci Med Sci 2021; 76:2178-2186. [PMID: 34153092 PMCID: PMC8598988 DOI: 10.1093/gerona/glab180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND In older adults, vision impairment (VI) is associated with worse cognitive function. However, the relationship between midlife vision and future cognitive function remains unknown. METHODS The Study of Women's Health Across the Nation, Michigan site, is a longitudinal cohort of midlife women aged 42-52 years at baseline. Presenting Titmus visual acuity (VA) in the better-seeing eye was assessed at baseline and categorized as no or mild VI (VA ≥20/60), or moderate or worse VI (VA <20/60). Cognitive function was measured 8 times over 15 years using the East Boston Memory Test immediate (EBMTi) and delayed (EBMTd) recall and the Digit Span Backwards (DSB) test. Linear mixed models with a random intercept and slope for age were constructed to detect associations between VI at baseline and future repeated measures of cognitive function, adjusting for age, race, education, financial strain, alcohol use, and tobacco use. RESULTS About 394 women aged 42-52 at baseline with a maximum follow-up of 20 years were included in this analysis. After covariate adjustment, moderate or worse VI was associated with lower EMBTi (β = -0.56, p = .012), EBMTd (β = -0.60, p = .009), and DSB (β = -0.84, p = .04). While we detected significant associations between VI and levels of cognitive function scores, rates of cognitive decline as individuals aged did not vary by VI status. CONCLUSION Moderate or worse VI, assessed during midlife, was associated with lower scores on measures of cognitive function over a 15-year period during which women transitioned from midlife to older adulthood.
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Affiliation(s)
- Ajay Kolli
- University of Michigan Medical School, University of Michigan, Ann Arbor, USA
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Michelle M Hood
- Department of Epidemiology, University of Michigan School of Public Health, University of Michigan, Ann Arbor, USA
| | - Carrie Karvonen-Gutierrez
- Department of Epidemiology, University of Michigan School of Public Health, University of Michigan, Ann Arbor, USA
| | - Sayoko E Moroi
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
- Department of Ophthalmology and Visual Sciences, Ohio State University Wexner Medical Center, The Ohio State University, Columbus, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
- Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Brenda W Gillespie
- Department of Biostatistics, University of Michigan School of Public Health, University of Michigan, Ann Arbor, USA
| | - Sarah Dougherty Wood
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
| | - David C Musch
- Department of Epidemiology, University of Michigan School of Public Health, University of Michigan, Ann Arbor, USA
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
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20
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Juang C, Huh JWT, Iyer S, Beaudreau SA, Gould CE. Feasibility, Acceptance, and Initial Evaluation of a Telephone-Based Program Designed to Increase Socialization in Older Veterans. J Geriatr Psychiatry Neurol 2021; 34:594-605. [PMID: 32744165 DOI: 10.1177/0891988720944242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Loneliness is a public health issue, particularly for older Veterans. To increase older Veterans' access for socialization opportunities, a community-based telephone-delivered activity program was developed, in which Veterans can call in and engage in social activities through telephone. This paper illustrates the feasibility, acceptance, and preliminary outcomes of this program using a mixed-methods design. Thirty-two Veterans enrolled in the program, with 14 attendees who called in to the program at least once. Attendees were more likely to be depressed than those who did not call in at baseline. Program was acceptable with high client satisfaction. Perceived benefits included a structured program with interesting topics to spend time on and the opportunity to socialize, exchange ideas, and connect with other Veterans. Individual challenges (e.g., hearing difficulty) and program-level challenges (e.g., complicated procedures) were reported during qualitative interviews. Among attendees, a significant decrease in loneliness from baseline to 3-months was found but should be interpreted with caution based on the small sample size. While positive findings emerged regarding feasibility, acceptance, preliminary benefits of this program, further refinement is needed to improve future program implementation.
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Affiliation(s)
- Christine Juang
- Psychology Service, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - J W Terri Huh
- Psychology Service, San Francisco VA Medical Center, San Francisco, CA, USA
| | - Sowmya Iyer
- Palo Alto Geriatric Research, Education, and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Sherry A Beaudreau
- Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Christine E Gould
- Palo Alto Geriatric Research, Education, and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Abstract
Early detection and monitoring are critical to the diagnosis and management of glaucoma, a progressive optic neuropathy that causes irreversible blindness. Optical coherence tomography (OCT) has become a commonly utilized imaging modality that aids in the detection and monitoring of structural glaucomatous damage. Since its inception in 1991, OCT has progressed through multiple iterations, from time-domain OCT, to spectral-domain OCT, to swept-source OCT, all of which have progressively improved the resolution and speed of scans. Even newer technological advancements and OCT applications, such as adaptive optics, visible-light OCT, and OCT-angiography, have enriched the use of OCT in the evaluation of glaucoma. This article reviews current commercial and state-of-the-art OCT technologies and analytic techniques in the context of their utility for glaucoma diagnosis and management, as well as promising future directions.
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Affiliation(s)
- Alexi Geevarghese
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY 10003, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA
| | - Joel S Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY 10003, USA
- Department of Physiology and Neuroscience, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA
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22
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Ma R, Romano E, Vancampfort D, Firth J, Stubbs B, Koyanagi A. Physical Multimorbidity and Social Participation in Adult Aged 65 Years and Older From Six Low- and Middle-Income Countries. J Gerontol B Psychol Sci Soc Sci 2021; 76:1452-1462. [PMID: 33786598 PMCID: PMC8363032 DOI: 10.1093/geronb/gbab056] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Multimorbidity is common among older adults from low- and middle-income countries (LMICs). Social participation has a role in protecting against negative health consequences, yet its association with multimorbidity is unclear, particularly in LMICs. Thus, this study investigated the relationship between physical multimorbidity and social participation among older adults across 6 LMICs. METHOD Cross-sectional, community-based data including adults aged 65 years and older from 6 LMICs were analyzed from the WHO Study on Global AGEing and adult health survey. The association between 11 individual chronic conditions or the number of chronic conditions (independent variable) and social participation (range 0-10 with higher scores indicating greater social participation; dependent variable) was assessed by multivariable linear regression analysis. RESULTS 14,585 individuals (mean age 72.6 [SD 11.5] years; 54.9% females) were included. Among individual conditions, hearing problems, visual impairment, and stroke were significantly associated with lower levels of social participation. Overall, an increasing number of chronic conditions was dose-dependently associated with lower levels of social participation (e.g., ≥4 vs 0 conditions: β = -0.26 [95% CI = -0.39, -0.13]). The association was more pronounced among males than females. DISCUSSION Older people with multimorbidity had lower levels of social participation in LMICs. Future longitudinal studies are warranted to further investigate temporal associations, and whether addressing social participation can lead to better health outcomes among older people with multimorbidity in LMICs.
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Affiliation(s)
- Ruimin Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, UK
| | - Eugenia Romano
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, UK
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Belgium
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, UK
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, UK
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Spain
- Institució Catalana de Recerca i Estudis Avancats (ICREA), Barcelona, Spain
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Lupón M, Cardona G, Armayones M. Public knowledge of low vision and blindness, and readability of on-topic online information. JOURNAL OF OPTOMETRY 2021; 14:240-246. [PMID: 32773209 PMCID: PMC8258127 DOI: 10.1016/j.optom.2020.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 05/29/2023]
Abstract
PURPOSE To explore the laymen knowledge of low vision and blindness concepts, and to assess the readability of some on-topic information available online. METHODS A cross-sectional study was performed in March 2019. Knowledge was evaluated by means of an ad hoc questionnaire-survey with two dichotomous questions about concepts related to low vision and blindness, followed with a list of 10 true-or-false statements. Readability of two on-topic online texts of different complexity was evaluated asking participants to rate the difficulty they experienced on a Likert scale and, objectively, by means of the freeware INFLESZ Readability Scale for Spanish language. Data analysis included descriptive statistics, t-tests, and ANOVA test (statistical significance: p < 0.05). RESULTS Fifty-two percent of 103 participants declared never having heard of low vision. Ninety-four percent participants were aware about the word blindness, although most of them misinterpreted it. Neither academic level nor age influenced knowledge (p > 0,05). Higher academic level was related to better readability scores of the complex online text (p < 0.05). CONCLUSION Overall, the general public has a limited awareness of low vision and a large misconception of blindness. Therefore, visual health education actions should aim at fostering knowledge and literacy on the issue. This strategy may encourage individuals to seek the advice of eye care providers in order to prevent and treat visual impairment, with relevant consequences in time, both in terms of quality of life and costs.
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Affiliation(s)
- Marta Lupón
- Psychology, Health & ICT (PSINET), Open University of Catalonia, Rambla del Poblenou 156, 08018, Barcelona, Spain; Vision, Optometry and Health (VOS) - Department of Optics and Optometry, Polytechnic University of Catalonia, Violinista Vellsolà 37, 08022, Terrassa, Spain.
| | - Genís Cardona
- Vision, Optometry and Health (VOS) - Department of Optics and Optometry, Polytechnic University of Catalonia, Violinista Vellsolà 37, 08022, Terrassa, Spain.
| | - Manuel Armayones
- e-Health Center, Open University of Catalonia, Rambla del Poblenou, 156, 08018, Barcelona, Spain.
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Social Participation as a Predictor of Morbid Thoughts and Suicidal Ideation among the Elderly Population: A Cross-Sectional Study on Four Low-Middle-Income Countries. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint2020013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Social wellbeing constitutes a critical aspect of one’s health, quality of life, and overall psychosocial wellbeing. Social isolation and perceived loneliness are growing public health concerns as they are considered to be important risk factor for poor physical and mental health outcomes. Not much is known about how the level of one’s social participation is associated with morbid thought and suicidal ideation. In the present study, we aimed to investigate whether social participation shows any significant correlation with morbid thought and suicidal ideation among the elderly population. Methods: Cross-sectional data were collected from Wave 1 of the Study of Global AGEing and Adult Health (SAGE). The sample population consisted 2018 men and women aged 65 years and above from the following countries: China (n = 787), Ghana (n = 278), India (n = 560), and Russia (n = 396). Outcome variables of self-reported occurrence of morbid thoughts and suicide ideation during the past 12 months were reported. Results: A great majority of the participants reported not participating in activities such as public meetings (84.6%), club meeting (49.6%), neighborhood activities (46%), and religious activities (57.2%). Those who reported attending public meetings several times a year had a higher likelihood of reporting having morbid thoughts (predicted probability = 1.24, 95% CI = 1.02, 1.52). However, the association was no longer significant after stratifying by sex. Attending clubs (marginal effect = 0.61, 95% CI = 0.49, 0.76) and neighborhood activities (predicted probability = 0.71, 95% CI = 0.58, 0.88) several times a year showed protective effects against morbid thoughts. Being visited by friends several times a month (predicted probability = 0.52, 95% CI = 0.40, 0.67) and visiting friends (predicted probability = 0.61, 95% CI = 0.50, 0.75) several times a year also showed lower likelihood of morbid thoughts. Similar effects were observed for attending social gatherings with colleagues and social events as well. Conclusions: The present findings suggest that there exist significantly positive associations between participation in social activities and morbid thoughts and suicidal ideation among the elderly population in the sample countries. More in-depth studies are necessary to investigate the barriers to participation in social activities as well as the role of the quality of social relationships with experiencing suicidal thoughts.
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Shang X, Zhu Z, Wang W, Ha J, He M. The Association between Vision Impairment and Incidence of Dementia and Cognitive Impairment: A Systematic Review and Meta-analysis. Ophthalmology 2021; 128:1135-1149. [PMID: 33422559 DOI: 10.1016/j.ophtha.2020.12.029] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 02/08/2023] Open
Abstract
TOPIC The magnitude and direction of the association between vision impairment and incident dementia and cognitive impairment in prospective cohort studies was estimated by systematic review and meta-analysis. The global burden of dementia associated with vision impairment then was estimated. CLINICAL RELEVANCE Because a predominant proportion of vision impairment is preventable or treatable, investigating its association with dementia may help to identify an important modifiable factor for the prevention of dementia. METHODS A literature search was conducted using PubMed, Embase, Web of Science, and Google Scholar on September 15, 2020. Relative risks (RRs) were pooled using random-effects models and stratified analyses for subgroups representing different study characteristics. Publication bias was evaluated with funnel plots and the Egger test. The global burden of dementia associated with vision impairment was estimated based on the Global Burden of Disease Study data on the prevalence of dementia and vision impairment. RESULTS In the meta-analysis of 14 prospective cohort studies with 6 204 827 participants and 171 888 dementia patients, the pooled RR associated with vision impairment was 1.47 (95% confidence interval [CI], 1.36-1.60). In the meta-analysis of 12 prospective cohort studies with 45 313 participants and 13 350 patients with cognitive impairment, the pooled RR was 1.35 (95% CI, 1.28-1.41). Stratified analyses showed that the associations of vision impairment with incident dementia and cognitive impairment were similar across methods of vision assessment, length of follow-up, and study quality. The global number of people with dementia associated with moderate or severe vision impairment in 2016 was 2.1 million (80% uncertainty interval, 1.0-3.3 million), which accounted for 4.7% (95% CI, 2.3%-7.5%) of the global burden of dementia. Economic inequality was significant for the burden of dementia associated with vision impairment. DISCUSSION The overall quality of the body evidence was low because of the observational design of the studies included in the analysis. Vision impairment is associated with an increased risk of both dementia and cognitive impairment in older adults. Screening and treating vision impairment, especially in low- and middle-income countries, may help to alleviate the global burden of dementia.
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Affiliation(s)
- Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jason Ha
- Centre for Eye Research Australia, Melbourne, Australia
| | - Mingguang He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China; Centre for Eye Research Australia, Melbourne, Australia.
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Hua ZQ, Liu H, Wang N, Jin ZB. Towards stem cell-based neuronal regeneration for glaucoma. PROGRESS IN BRAIN RESEARCH 2020; 257:99-118. [PMID: 32988476 DOI: 10.1016/bs.pbr.2020.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Glaucoma is a neurodegenerative disease as a leading cause of global blindness. Retinal ganglion cell (RGC) apoptosis and optic nerve damage are the main pathological changes. Patients have elevated intraocular pressure and progressive visual field loss. Unfortunately, current treatments for glaucoma merely stay at delaying the disease progression. As a promising treatment, stem cell-based neuronal regeneration therapy holds potential for glaucoma, thereby great efforts have been paid on it. RGC regeneration and transplantation are key approaches for the future treatment of glaucoma. A line of studies have shown that a variety of cells can be used to regenerate RGCs, including embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), mesenchymal stem cells (MSCs), and retinal progenitor cells (RPCs). In this review, we overview the current progress on the regeneration of pluripotent stem cell-derived RGCs and outlook the perspective and challenges in this field.
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Affiliation(s)
- Zi-Qi Hua
- Laboratory of Stem Cell & Retinal Regeneration, Institute of Stem Cell Research, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hui Liu
- Laboratory of Stem Cell & Retinal Regeneration, Institute of Stem Cell Research, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
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Association between Active Helicobacter pylori Infection and Glaucoma: A Systematic Review and Meta-Analysis. Microorganisms 2020; 8:microorganisms8060894. [PMID: 32545826 PMCID: PMC7355761 DOI: 10.3390/microorganisms8060894] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Glaucoma is the second most common cause of blindness worldwide affecting almost 70 million individuals. Helicobacter pylori (H. pylori) is a widespread pathogen with systematic pathogenicity. This meta-analysis aimed to estimate the contradictory data regarding a potential association between active H. pylori infection and glaucoma. Materials and Methods: A research in MEDLINE/PubMed and Google Scholar was conducted and original studies investigating the relationship between H. pylori infection and glaucoma were included. Analysis was performed with random effects model. The main outcome was the odds ratio (OR) with 95% confidence intervals (CI) of H. pylori infection as a risk factor for glaucoma. A parallel analysis studied the role of active infection as indicated by histology and the titer of anti-H. pylori antibodies. For the anti-H. pylori antibody titers, weighted mean differences (WMD) were estimated between patients and controls. Results: Fifteen studies were included, with 2664 participants (872 patients with glaucoma and 1792 controls), divided into primary open-angle glaucoma (POAG), normal tension glaucoma (NTG) and pseudo-exfoliation glaucoma (PEG). The association between H. pylori infection and overall glaucoma was significant (OR = 2.08, CI 95% 1.48–2.93) with moderate heterogeneity (I2 = 61.54%). After stratification by glaucoma subtype, heterogeneity was eliminated in the NTG subgroup. Studies with healthy controls, and controls with anemia yielded very low or no heterogeneity, respectively. Gastric biopsy to document active H. pylori infection yielded the highest OR (5.4, CI: 3.17–9.2, p < 0.001) and null heterogeneity. For anti-H. pylori antibody titers, there was a significant difference in WMD between patients and controls (WMD 15.98 IU/mL; 95% CI: 4.09–27.87; p = 0.008); values were greater in glaucoma patients, with high heterogeneity (I2: 93.8%). Meta-regression analysis showed that mean age had a significant impact on glaucoma (p = 0.037). Conclusions: Active H. pylori infection may be associated with glaucoma with null heterogeneity, as, beyond histology, quantified by anti-H. pylori titers and increases with age.
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Senjam SS. Glaucoma blindness-A rapidly emerging non-communicable ocular disease in India: Addressing the issue with advocacy. J Family Med Prim Care 2020; 9:2200-2206. [PMID: 32754474 PMCID: PMC7380776 DOI: 10.4103/jfmpc.jfmpc_111_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/12/2020] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
Glaucoma, a leading cause of irreversible blindness, can be prevented or stabilized the progression if identified early and managed it appropriately. In India, around 12 million people suffer from glaucoma, and 1.5 million are blind due to it, so making the third most common cause of blindness. More than 75% of glaucoma are undiagnosed, which perhaps represent the submerged portion of the iceberg phenomenon of the traditional disease explanations. Though glaucoma per se does not lead to mortality, glaucoma blindness is categorized as a severe form of disability (category VI) out of seven World Health Organization (WHO) classification on the global burden of diseases. Indeed, there is a large gap between the prevailing burden of glaucoma and service being delivered about its prevention compared to other leading causes of blindness in India. Considering the magnitude of the problem as well as the severity of disability, a strong and effective advocacy is an urgent call to deal glaucoma problem in the country. For a resource-limited country, where mass population based-screening programs are not feasible, alternative methods like facility-based opportunistic screening and referring the high-risk groups for early detection and treatment should be aimed. However, glaucoma should not be screened in isolation from other eye problems. In fact, screening of any potential blinding ocular problems, including glaucoma, should be a clear mandate under comprehensive eye program of the WHO to achieve Universal Eye Health Coverages. This paper highlights the strategy inclusive of advocacy to curtail the increasing burden of glaucoma blindness in India.
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Affiliation(s)
- Suraj Singh Senjam
- Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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