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Visual acuity change and mortality in older adults
Ellen E Freeman1, Brian L Egleston, Sheila K West
1Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Baltimore, MD 21250, USA. efreeman@jhsph.edu
Investigative Ophthalmology & Visual Science
|October 27, 2005
Summary
Visual acuity loss in older adults is linked to increased mortality risk. Depressive symptoms did not mediate this relationship, suggesting other factors are involved.
Area of Science:
- Ophthalmology and Gerontology
- Public Health
- Epidemiology
Background:
- Studies suggest a correlation between visual impairment and increased mortality in older adults.
- Potential causal mechanisms linking vision loss to mortality remain underexplored.
Purpose of the Study:
- To investigate if decreased visual acuity elevates mortality risk in the elderly.
- To determine if depressive symptoms mediate the relationship between visual acuity and mortality.
Main Methods:
- Prospective 8-year cohort study of 2520 older adults (Salisbury Eye Evaluation project).
- Visual acuity measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) eye chart.
- Depressive symptoms assessed via the General Health Questionnaire Part D subscale; mortality data collected through follow-up.
- Cox proportional hazards regression analysis employed.
Main Results:
- Worse baseline visual acuity correlated with higher mortality rates (HR=1.05).
- Improved visual acuity (≥2 lines over 2 years) was associated with lower mortality risk (HR=0.47).
- Women experiencing significant vision loss (≥3 lines over 2 years) showed a markedly higher mortality risk (HR=3.97), unlike men.
- Depressive symptoms did not function as a mediator in these associations.
Conclusions:
- The link between visual acuity and mortality is likely multifactorial, involving various intervening variables.
- Identifying these intervening variables could offer novel targets for interventions when vision restoration is not possible.