Prevalence Factors Associated With Vision Impairment and Blindness Among Individuals 85 Years and Older in Russia

Abstract

IMPORTANCE Visual performance is important for quality of life. However, vision impairment among adults 85 years and older has not been intensively examined.OBJECTIVE To assess the prevalence of mild vision impairment (VI), moderate to severe vision impairment, and blindness and the factors associated with these conditions among a population 85 years and older. DESIGN, SETTING, AND PARTICIPANTSThe Ural Very Old Study was a population-based cohort study conducted in rural and urban areas in Bashkortostan, Russia from 2017 to 2020. Among 1882 eligible individuals 85 years and older, 1526 participants (81.1%) were enrolled. EXPOSURES Ophthalmologic, physical, and mental examinations. MAIN OUTCOMES AND MEASURES Prevalence of vision impairment and blindness based on best-corrected visual acuity (BCVA; measured using modified Early Treatment of Diabetic Retinopathy Study charts) in the better eye or both eyes. Mild vision impairment was defined as BCVA worse than 6/12 to 6/18, and moderate to severe VI was defined as BCVA worse than 6/18 but equal to or better than 3/60. Blindness was defined as BCVA worse than 3/60. RESULTS Among 1526 participants, 1149 individuals (75.3%; 846 women [73.6%]; mean [SD] age, 88.2 [2.8 years]) had available BCVA measurements and were included in the present analysis. Mild vision impairment was present in 114 individuals (9.9%; 95% CI, 8.2%-11.7%), moderate to severe VI in 562 individuals (48.9%; 95% CI, 46.0%-51.8%), and blindness in 68 individuals (5.9%; 95% CI, 4.6%-7.3%). Factors associated with moderate to severe VI were cataracts (324 individuals [57.7% of those with moderate to severe VI and 28.2% of total population; 95% CI, 25.6%-30.8%]), secondary cataracts (4 individuals [0.7% of those with moderate to severe VI and 0.3% of total population; 95% CI, 0%-0.7%]), age-related macular degeneration (78 individuals [13.9% of those with moderate to severe VI and 6.8% of total population; 95% CI, 5.3%-8.3%]), glaucoma (45 individuals [8.0% of those with moderate to severe VI and 3.9% of total population; 95% CI, 2.8%-5.0%]), corneal opacifications (26 individuals [4.6% of those with moderate to severe VI and 2.3% of total population; 95% CI, 1.4%-3.1%]), myopic maculopathy (13 individuals [2.3% of those with moderate to severe VI and 1.1% of total population; 95% CI, 0.5%-1.7%]), and nonglaucomatous optic nerve damage (4 individuals [0.7% of those with moderate to severe VI and 0.3% of total population; 95% CI, 0%-0.7%]). Factors associated with blindness were cataracts (33 individuals [48.5% of those with blindness and 2.9% of total population; 95% CI, 1.9%-3.8%]), age-related macular degeneration (15 individuals [22.1% of those with blindness and 1.3% of total population; 95% CI, 0.7%-2.0%]), glaucoma (7 individuals [10.3% of those with blindness and 0.6% of total population; 95% CI, Key PointsQuestion What is the prevalence of Open Access. This is an open access article distributed under the terms of the CC-BY License.

Prevalence and associated factors of osteoarthritis in the Ural Eye and Medical Study and the Ural Very Old Study

“…The UVOS is a population-based study, which was conducted in the same study regions as the UEMS, and which was performed in the period from 2017 to 2020 19 . The study was approved by the Ethics Committee of the Academic Council of the Ufa Eye Research Institute (protocol number 3, dated 10.8.2017) and informed written consent was obtained from all participants.…”

Prevalence of metabolic syndrome in a Russian population: The Ural Eye and Medical Study and the Ural Very Old Study

“…There were no retirement homes in the rural study region. As already described recently, the participation rate did not vary markedly between the urban group (1238 (81.3%) out of 1523 individuals) and the rural group (288 (80.2%) out of 359 individuals) [ 17 ]. According to the census carried out in Russia in 2010, the composition of the population of the UVOS with respect to gender and age corresponded to the gender and age distribution in the Russian population beyond an age of 85+ years, with a marked preponderance of females [ 16 ].…”

“…The UVOS is a population-based study, which was conducted in the period from 2017 to 2020 in similar, but not the same, study regions as the UEMS was performed [ 17 ]. The study was approved by the Ethics Committee of the Academic Council of the Ufa Eye Research Institute and informed written consent was obtained from all participants.…”

“…Those UVOS participants being too immobile for the transport, were examined at their homes. As also described in detail previously, the series of examinations started with a detailed interview consisting of more than 250 standardized questions on the socioeconomic background, including the self-reported ethnicity, level of education, occupation, family income and family estate (ownership of a house and second house, telephone, smartphone, laptop, television, bicycle and car), and size and structure of the family; diet (number of meals per day, frequency and amount of intake of vegetables, fruits, whole grain and meat, consumption of tea and coffee, use of animal fat or cooking oil); smoking (since when or stopped, cigarettes or other types of tobacco products, symptoms of smoking cessation); alcohol consumption (since when or stopped, alcohol consumption-related wrongdoing); physical activity (frequency and intensity of daily work, leisure time activities, sitting or reclining); quality of life and quality of vision; symptoms of chronic obstructive pulmonary disease (COPD), asthma, kidney disease and orthopedic disorders; history of any type of injuries and inter-personal violence; and health assessment questions [ 15 , 17 ]. The questionnaire additionally included questions on the medical history including known diagnosis and therapy of major disorders such as diabetes mellitus, arterial hypertension, cardiovascular diseases, headache, neck pain, thoracic spine and low back pain, depression, suicidal ideas, anxiety, questions on previous neurologic attacks including stroke, epilepsy, polyneuropathy and unconsciousness, and questions on cognitive function and hearing loss.…”

“…The questionnaire additionally included questions on the medical history including known diagnosis and therapy of major disorders such as diabetes mellitus, arterial hypertension, cardiovascular diseases, headache, neck pain, thoracic spine and low back pain, depression, suicidal ideas, anxiety, questions on previous neurologic attacks including stroke, epilepsy, polyneuropathy and unconsciousness, and questions on cognitive function and hearing loss. All questions included in the interview were taken from standardized interviews published in the literature, such as the “Center for Epidemiologic Studies Depression Scale (CES-D) Scoresheet”, the Folstein test, Zung's self-rated depression scale, the National Eye Institute Visual Functioning Questionnaire-25 (VFQ-25), the Questionnaire for Verifying Stroke-Free Status (QVSFS) from the American Heart Association, and the Michigan Neuropathy Screening Instrument [ 15 , 17 ].…”