Prevalence of Nonrefractive Visual Impairment in US Adults and Associated Risk Factors, 1999-2002 and 2005-2008

Ko, Fang; Vitale, Susan; Chou, Chiu Fang; Cotch, Mary Frances; Saaddine, Jinan B.; Friedman, David S.

doi:10.1001/jama.2012.85685

Cited by 72 publications

(62 citation statements)

References 26 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(30) They are also similar to findings from a recent observational study in Finland that demonstrated a significant association between diabetic lower extremity amputation rate and socioeconomic status, with an approximately two-fold increase from lowest to highest socioeconomic status strata, despite universal access to health services. (10)…”

Section: Discussionsupporting

confidence: 87%

Geographic Clustering Of Diabetic Lower-Extremity Amputations In Low-Income Regions Of California

Stevens

Schriger²,

Raffetto

et al. 2014

Health Affairs

View full text Add to dashboard Cite

A large body of work demonstrates income-related disparities in access to coordinated preventive care in patients with diabetes and other chronic conditions. Much less information exists on associations between poverty and consequential negative health outcomes. Few studies have assessed geographic patterns linking household incomes to major, preventable complications of chronic diseases. Using statewide facility discharge data for California during 2009, we identified 7,973 lower extremity amputations in 6,828 diabetic adults. We mapped amputation events based on residential zip codes, and used US census data to produce corresponding maps of poverty rate. Comparisons of the maps show amputation “hotspots” in lower income urban and rural regions of California. Prevalence-adjusted amputation rates varied ten-fold between high-income and low-income regions. While our analysis does not support detailed causal inferences, our method for mapping complication “hot spots” using existing public data sources may help target interventions to communities most in need.

show abstract

Section: Discussionsupporting

confidence: 87%

Geographic Clustering Of Diabetic Lower-Extremity Amputations In Low-Income Regions Of California

Stevens

Schriger²,

Raffetto

et al. 2014

Health Affairs

View full text Add to dashboard Cite

show abstract

“…Older age has been associated with visual impairment in numerous studies. [2,15-16,18-19,21-29] However, the differential impact of sex on visual impairment has been inconsistent in the literature with some studies finding no differences between men and women. [14-15,19,22,25] Among studies where significant sex differences were present, women were more likely to have visual impairment compared to men, [2,16,23-24,27-29] consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

“…[14,16,21,25] Conversely, higher socioeconomic status (education, income and having health insurance) was generally associated with lower risk of visual impairment in some, but not all, groups. The fact that older people with existing refractive correction could have good vision but do not, indicates that the socio-cultural issues underlying correctable visual impairment are not fully known.…”

Section: Discussionmentioning

confidence: 99%

Visual Impairment in White, Chinese, Black, and Hispanic Participants from the Multi-Ethnic Study of Atherosclerosis Cohort

Fisher

Shrager

Shea

et al. 2015

Ophthalmic Epidemiology

Self Cite

View full text Add to dashboard Cite

Purpose To describe the prevalence of visual impairment and examine its association with demographic, socioeconomic, and health characteristics in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Methods Visual acuity data was obtained from 6134 participants, aged 46 to 87 years old at time of examination between 2002 and 2004 (mean age 64 years, 47.6% male), from six communities in the United States (U.S.). Visual impairment was defined as a presenting visual acuity of 20/50 or worse in the better-seeing eye. Risk factors were included in multivariable logistic regression models to determine their impact on visual impairment for men and women in each racial/ethnic group. Results Among all participants, 6.6% (N=421) had visual impairment, including 5.6% (N=178) of men and 7.5% (N=243) of women. Prevalence of impairment ranged from 4.2% (N=52) and 6.0% (N=77) in White men and women, respectively, to 7.6% (N=37) and 11.6% (N=44) in Chinese men and women, respectively. Older age was significantly associated with visual impairment in both men and women, particularly in those with lower socioeconomic status, but the effects of increasing age were more pronounced in men. Two-thirds of participants already wore distance correction and not unexpectedly, lower prevalence of visual impairment was seen in this group; however, 2.4% of men and 3.5% of women with current distance correction had correctable visual impairment, most notably among seniors. Conclusion Even in the United States where prevalence of refractive correction is high, both visual impairment and uncorrected refractive error represent current public health challenges.

show abstract

“…For example, the obesity epidemic in the United States has led to an increase in the prevalence of diabetic retinopathy. 68 More effective strategies targeting obesity have clear implications for ocular health. Moreover, the early detection of disabling eye diseases is suboptimal in the US health care system, leading to otherwise preventable VI.…”

Section: Study Implicationsmentioning

confidence: 99%

Longitudinal Relationships Among Visual Acuity, Daily Functional Status, and Mortality

et al. 2014

View full text Add to dashboard Cite

IMPORTANCE Determination of the mechanisms by which visual loss increases mortality risk is important for developing interventional strategies. OBJECTIVE To evaluate the direct and indirect effects of loss of visual acuity (VA) on mortality risk through functional status changes among aging adults. DESIGN, SETTING, AND PARTICIPANTS Prospective longitudinal study of a population-based sample of 2520 noninstitutionalized adults aged 65 to 84 years from September 16, 1993, through July 26, 2003, in the greater Salisbury area of Maryland. Participants underwent reassessment 2, 6, and 8 years after baseline. Mortality status was ascertained from linkage with the National Death Index through 2009.EXPOSURES Results of VA testing and self-reported functional status based on activities of daily living (ADL) and instrumental ADL (IADL). MAIN OUTCOMES AND MEASURE Mortality.RESULTS Worse VA levels at baseline were associated with an increased the risk for mortality (hazard ratio [HR], 1.16 [95% CI, 1.04-1.28]; P < .01) through their effect on lower IADL levels at baseline. Declines in VA over time were associated with increased mortality risk (HR, 1.78 [95% CI, 1.27-2.51]; P < .001) by way of decreasing IADL levels over time. Participants experiencing the mean linear decline in VA of 1 letter on the Early Treatment Diabetic Retinopathy Study acuity chart per year are expected to have a 16% increase in mortality risk during the 8-year study exclusively through associated declines in IADL levels. CONCLUSIONS AND RELEVANCEIn this longitudinal study of older adults, VA loss adversely affected IADL levels, which subsequently increased the risk for mortality. Prevention of disabling ocular conditions, treatment of correctable visual impairment, and interventions designed to prevent the effect of visual impairment on IADL declines may all reduce mortality risk in aging adults.

show abstract

Prevalence of Nonrefractive Visual Impairment in US Adults and Associated Risk Factors, 1999-2002 and 2005-2008

Cited by 72 publications

References 26 publications

Geographic Clustering Of Diabetic Lower-Extremity Amputations In Low-Income Regions Of California

Geographic Clustering Of Diabetic Lower-Extremity Amputations In Low-Income Regions Of California

Visual Impairment in White, Chinese, Black, and Hispanic Participants from the Multi-Ethnic Study of Atherosclerosis Cohort

Longitudinal Relationships Among Visual Acuity, Daily Functional Status, and Mortality

Contact Info

Product

Resources

About