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Age-related macular degeneration and mortality: the Melbourne Collaborative Cohort Study
M B McGuinness1,2,3, R P Finger1,3,4, A Karahalios2
1Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Eye (London, England)
|August 19, 2017
Summary
Late age-related macular degeneration (AMD) is linked to increased mortality. Specifically, choroidal neovascularisation and geographic atrophy correlate with higher risks of death from cardiovascular disease and cancer, respectively.
Area of Science:
- Ophthalmology
- Gerontology
- Epidemiology
Background:
- Age-related macular degeneration (AMD) is a leading cause of vision loss in older adults.
- Understanding the systemic health implications of AMD, particularly mortality risk, is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the association between specific features of age-related macular degeneration (AMD) and all-cause and cause-specific mortality.
- To determine if different AMD phenotypes, including late AMD, are predictive of mortality outcomes.
Main Methods:
- A cohort of 21,129 participants (aged 47-85) from the Melbourne Collaborative Cohort Study were assessed for AMD.
- Mortality data up to December 31, 2012, were linked via the National Death Index.
- Cox regression models were used to assess associations, adjusting for various demographic and lifestyle factors.
Main Results:
- Late AMD was identified in 0.6% of participants.
- Choroidal neovascularisation (CNV) and geographic atrophy (GA) were associated with increased all-cause mortality (HR 1.71 and 1.46, respectively).
- CNV showed a strong association with cardiovascular mortality (HR 3.16), while GA was linked to tobacco-related cancer mortality (HR 2.86).
Conclusions:
- Late-stage AMD is a significant risk factor for increased all-cause mortality.
- Specific features of late AMD, namely CNV and GA, are independently associated with mortality from cardiovascular diseases and tobacco-related cancers, respectively.
- Early AMD stages and reticular pseudodrusen were not associated with mortality in this cohort.
