The Schirmer test was shown to be incapable of detecting meibomian gland disease. However, a low Schirmer result was significantly associated with dry-eye symptoms in this elderly Chinese population. This result differs from that of previous reports of elderly white populations. Further studies are needed to determine whether this difference indicates racial diversity in the distribution and behavior of dry-eye diseases.

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The prevalence of myopia in this elderly Chinese population is not much higher than in similarly aged elderly white populations, compared with a much greater difference in prevalence among younger Chinese versus white people. This suggests that changing environmental factors may account for the increased prevalence of myopia in younger cohorts of Chinese.

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Health-related quality of life (HRQOL) measures predict cause-specific mortality, but few studies have explored whether generic self-reported HRQOL measures are independently associated with mortality in community-dwelling older persons. We postulated that a general measure of HRQOL, the short form 36-item questionnaire (SF-36), would be independently predictive of mortality among community-dwelling older persons. To evaluate this hypothesis, we followed a fixed cohort of 4,424 community-dwelling older persons recruited from a 2000 population-based survey in Taiwan until 2003 and investigated whether HRQOL was predictive of 3-year mortality, even after adjusting for traditional clinical risk variables. The data were collected via a door-to-door survey, and interviewers collected information on the subjects' demographics, medical history, utilization of health services, functional ability, falls, and self-reported physical and mental symptoms. Of the 6053 eligible subjects, 4,424 residents agreed to participate in the baseline survey and were contacted in 2003. During the 3-year period, the 3-year cumulative mortality rate for the study population was 5%. Mortality was significantly higher among males (5.57% vs. 4.27%, p = 0.049), and cumulative mortality increased with age (chi (2)-test for trend; chi (2) = 7.734, p = 0.001). For all scales except bodily pain, there was a significant relationship between a 10-point lower baseline score and mortality. Our primary multivariate risk model, which included two summary measures of HRQOL and significant clinical variables, demonstrated that a 10-point decrease in either the baseline Physical Component Summary (PCS) score or the baseline Mental Component Summary (MCS) score was associated with higher mortality (PCS: RR: 1.60, 95% CI: 1.39-1.83; p < 0.001; MCS: RR: 1.16, 95% CI: 1.01-1.34; p = 0.036). The findings suggested that low baseline PCS and MCS scores were important independent risk factors for 3-year mortality among community-dwelling older persons, even after adjusting for other risk factors.

The results demonstrate that approximately 10% of the senior population in the Shihpai district has a correctable visual impairment. Thus, it is important to educate the public about the importance of regular examination and the possibility of improving visual acuity by wearing glasses.

To determine the distribution of intraocular pressure (IOP) as measured by a noncontact tonometer (NCT) and risk factors responsible for ocular hypertension in elderly Chinese people. Design: Population-based study of randomly sampled Chinese people 65 years and older in Shihpai, Taipei, Taiwan. Main Outcome Measures: Participants completed an interview and underwent a physical examination and a standardized ophthalmic examination, including IOP measurement with the NCT. People with a history of glaucoma were excluded. Risk factors were assessed using multivariate regression analysis. Results: Of 1361 study participants examined, 1292 (95.4%) had no history of glaucoma and were therefore included in the study. Their mean±SD IOP was 12.9±3.1 mm Hg. The IOP decreased significantly (PϽ.001) with age, changing from 13.3±3.0 mm Hg in participants aged 65 to 69 years to 11.6±2.8 mm Hg in those 80 years and older. Women had significantly higher IOP than men (PϽ.001). In the multivariate regression analysis, decreasing age, female sex, increasing systolic blood pressure, a history of diabetes, and alcohol drinking were significantly associated with increasing IOP. Conclusions: The distribution of IOP in elderly Chinese people is similar to that found in other East Asian people, with a negative age-IOP relationship. The mean IOP values in this elderly Chinese population were lower than in white people but higher than in Japanese people in similarly aged groups. Establishing the epidemiologic characteristics of IOP with the NCT is important for the mass screening of ocular hypertension.