Background
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The relationship between physical multimorbidity and visual impairment in the population over 50 years old.
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The relationship between visual impairment and mental health (depression and anxiety) in the population over 50 years old.
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The relationship between visual impairment and cognitive functioning in the population over 50 years old.
Methods
Design
Sample and procedures
Data collection
Statistical analysis
Ethics statement
Results
Participant characteristics
Total sample (n = 4583) | 18-49 years (n = 958) | 50-64 years (n = 1760) | ≥65 years (n = 1865) |
p
| |
---|---|---|---|---|---|
Age (mean; SE) | 47.6 (0.3) | 35.7 (0.30) | 57.0 (0.1) | 74.9 (0.1) | |
Education (n; %) | <0.001 | ||||
No education | 1269 (16.64%) | 62 (6.53%) | 311 (16.62%) | 896 (46.70%) | |
Primary | 1265 (24.93%) | 190 (20.92%) | 548 (32.81%) | 527 (29.84%) | |
Secondary | 1423 (39.29%) | 474 (48.07%) | 638 (35.42%) | 311 (16.61%) | |
≥University | 625 (19.14%) | 232 (24.48%) | 263 (15.15%) | 130 (6.80%) | |
Gender (n; %) | 0.006 | ||||
Male | 2078 (49.4%) | 435 (51.35%) | 829 (47.70%) | 814 (44.95%) | |
Female | 2505 (50.6%) | 523 (48.65%) | 931 (52.30) | 1051 (55.04%) | |
Marital status (n; %) | <0.001 | ||||
Single | 667 (27.3%) | 357 (39.18%) | 187 (10.39%) | 123 (6.75%) | |
Married | 2777 (56.6%) | 519 (53.12%) | 1238 (71.10%) | 1020 (54.18%) | |
Separated/divorced | 342 (7.1%) | 76 (7.21%) | 196 (10.86%) | 70 (3.36%) | |
Widowed | 797 (9.0%) | 6 (0.49%) | 139 (7.64%) | 652 (35.72%) | |
Urbanicity (n; %) | 0.216 | ||||
Urban | 3958 (84.78%) | 820 (85.40%) | 1523 (83.69%) | 1615 (83.93%) | |
Rural | 625 (15.22%) | 138 (14.60%) | 237 (16.31%) | 250 (16.07%) | |
Employment (n; %) | <0.001 | ||||
Working | 1360 (46.21%) | 543 (61.34%) | 773 (47.47%) | 44 (2.28%) | |
Retired | 1387 (16.43%) | 2 (0.24%) | 183 (11.35%) | 1202 (66.56%) | |
Other | 1611 (37.36%) | 342 (38.41%) | 681 (41.18%) | 588 (31.16%) |
Total | 18-49 years | 50-64 years | ≥65 years |
p (age) | |
---|---|---|---|---|---|
Angina
| 2.84 (2.44-3.29) | 0.4 (0.2-0.9) | 3.8 (2.9-4.9) | 9.2 (7.9-10.7) | <0.001 |
Asthma
| 4.83 (4.11-5.67) | 3.9 (2.9-5.1) | 4.3 (3.5-5.4) | 8.1 (6.7-9.7) | <0.001 |
Hypertension
| 16.55 (15.48-17.68) | 3.4 (2.3-5.0) | 23.4 (21.3-25.7) | 49.7 (47.4-52.0) | <0.001 |
Edentulism
| 9.03 (7.67-10.60) | 2.8 (1.6-5.0) | 8.2 (6.8-9.9) | 28.3 (25.0-31.8) | <0.001 |
Diabetes
| 6.66 (5.95-7.45) | 2.0 (1.3-3.0) | 9.5 (7.9-11.3) | 18.1 (16.2-20.1) | <0.001 |
Arthritis
| 13.72 (12.66-14.84) | 5.4 (4.2-7.0) | 18.4 (16.4-20.6) | 34.3 (31.8-36.9) | <0.001 |
Chronic Lung D
| 3.35 (2.83-3.95) | 1.2 (0.7-2.1) | 4.0 (3.1-5.1) | 9.1 (7.7-10.8) | <0.001 |
Stroke
| 2.13 (1.71-2.64) | 0.5 (0.3-1.2) | 2.4 (1.6-3.5) | 6.6 (5.3-8.3) | <0.001 |
Depression
| 8.97 (7.88-10.19) | 7.0 (5.5-8.8) | 12.0 (9.8-14.5) | 12.2 (10.6-13.9) | <0.001 |
Anxiety
| 1.09 (0.77-1.54) | 0.9 (0.5-1.7) | 1.8 (1.3-2.5) | 1.0 (0.7-1.6) | 0.120 |
Number of physical conditions
| |||||
0
| 64.4 (62.7-66.1) | 82.8 (80.3-85.0) | 53.0 (49.4-56.5) | 19.9 (17.9-22.1) | <0.001 |
1
| 21.3 (19.9-22.7) | 15.3 (13.2-17.7) | 29.7 (27.3-32.3) | 31.5 (29.7-33.4) | <0.001 |
2
| 8.1 (7.5-8.8) | 1.4 (0.9-2.2) | 10.3 (8.8-12.1) | 26.3 (24.2-28.5) | <0.001 |
≥3
| 6.2 (5.6-6.8) | 0.5 (0.2-1.2) | 7.0 (5.8-8.3) | 22.3 (20.1-24.7) | <0.001 |
TOTAL | 18-49 years | 50-64 years | > 65 years |
p(age) |
p(sex) | ||||
---|---|---|---|---|---|---|---|---|---|
Men | Women | Men | Women | Men | Women | ||||
Objective DVA
| <0.001 | 0.113 | |||||||
≥6/18 | 79.7 (76.3-82.8) | 81.6 (76.0-86.1) | 86.2 (82.2-89.4) | 83.2 (79.8-86.1) | 79.7 (75.2-83.7) | 69.4 (64.3-74.0) | 62.5 (57.7-67.1) | ||
6/60 | 16.7 (13.9-20.0) | 17.0 (12.6-22.4) | 11.9 (8.9-15.6) | 15.1 (12.3-18.3) | 17.7 (14.2-21.9) | 21.9 (18.3-26.1) | 25.3 (21.6-29.5) | ||
3/60 | 2.9 (2.3-3.8) | 1.4 (0.5-3.9) | 1.6 (0.8-3.2) | 1.7 (1.0-2.9) | 2.3 (1.5-3.7) | 7.0 (5.1-9.4) | 9.3 (7.4-11.7) | ||
<3/60 | 0.6 (0.4-0.9) | 0.1 (0.0-0.7) | 0.3 (0.1-1.6) | 0.1 (0.0-0.4) | 0.2 (0.1-0.5) | 1.7 (1.0-3.0) | 2.8 (1.8-4.5) | ||
Objective NVA
| <0.001 | <0.001 | |||||||
Smallest letter | 68.8 (66.4-71.1) | 84.7 (81.0-87.99 | 80.0 (76.5-83.1) | 59.6 (55.8-63.3) | 53.7 (49.1-58.3) | 43.0 (38.0-48.1) | 33.8 (30.1-37.6) | ||
Medium letter | 28.6 (26.5-30.9) | 14.5 (11.5-18.2) | 18.6 (15.6-22.0) | 38.1 (34.4-41.9) | 43.4 (39.2-47.8) | 50.8 (46.0-55.5) | 57.9 (53.6-62.1) | ||
Large letter | 2.1 (1.6-2.7) | 0.5 (0.2-1.7) | 1.4 (0.6-2.9) | 2.1 (1.3-3.3) | 2.3 (1.4-3.8) | 5.1 (3.9-6.8) | 5.9 (4.5-7.7) | ||
Not large letter | 0.5 (0.3-0.8) | 0.2 (0.0-1.4) | 0 | 0.2 (0.1-0.8) | 0.5 (0.2-1.4) | 1.1 (0.5-2.4) | 2.5 (1.5-4.1) | ||
Subjective DVA
| <0.001 | <0.001 | |||||||
None | 87.8 (86.3-89.3) | 93.2 (89.7-95.6) | 93.4 (90.9-95.3) | 89.9 (87.2-92.0) | 83.9 (80.4-86.8) | 78.5 (74.8-81.8) | 67.5 (62.8-71.9) | ||
Mild | 8.3 (7.1-9.6) | 5.4 (3.4-8.5) | 5.0 (3.4-7.2) | 8.2 (6.2-10.9) | 12.0 (9.5-15.1) | 14.1 (11.6-16.9) | 17.0 (13.9-20.6) | ||
Moderate | 2.8 (2.3-3.5) | 0.8 (0.2-3.4) | 1.4 (0.8-2.6) | 1.5 (0.9-2.5) | 3.2 (2.2-4.5) | 5.7 (4.2-7.6) | 10.7 (8.8-13.1) | ||
Severe | 1.1 (0.8-1.4) | 0.6 (0.2-1.5) | 0.2 (0.2-0.2) | 0.4 (0.2-1.1) | 1.0 (0.5-1.9) | 1.8 (1.1-2.9) | 4.7 (3.5-6.3) | ||
Subjective NVA
| <0.001 | 0.506 | |||||||
None | 89.2 (87.7-90.6) | 93.1 (89.7-95.4) | 96.2 (94.5-97.3) | 88.3 (85.5-90.6) | 85.7(82.0-88.8) | 81.4 (77.7-84.7) | 70.5 (65.6-74.9) | ||
Mild | 8.0 (6.8-9.4) | 5.4 (3.4-8.6) | 3.2 (2.1-4.8) | 8.6 (6.6-11.2) | 11.4 (8.7-15.0) | 13.3 (10.8-16.3) | 19.9 (16.4-24.1) | ||
Moderate | 2.2 (1.7-2.9) | 1.0 (0.3-3.5) | 0.6 (0.3-1.6) | 2.8 (1.7-4.6) | 2.6 (1.7-3.8) | 4.4 (3.1-6.3) | 7.3 (5.6-9.4) | ||
Severe | 0.5 (0.4-0.8) | 0.5 (0.2-1.4) | 0 | 0.3 (0.1-0.9) | 0.3 (0.1-0.8) | 0.8 (0.4-1.7) | 2.3 (1.5-3.5) |
Association between physical health and visual acuity
DVA (OR) | DVA (AOR) | NVA (OR) | NVA (AOR) | |
---|---|---|---|---|
Angina
| 1.57 (1.17-2.11) | 1.12 (0.84-1.51) | 1.43 (1.07-1.91) | 1.07 (0.78-1.48) |
Asthma
| 1.42 (1.04-1.95) | 1.02 (0.72-1.44) | 1.38 (0.99-1.93) | 1.04 (0.70-1.54) |
Hypertension
| 1.28 (1.08-1.52) | 0.87 (0.73-1.04) | 1.51 (1.23-1.78) | 1.10 (0.94-1.28) |
Edentulism
| 1.70 (1.33-2.18) | 1.12 (0.89-1.43) | 1.74 (1.42-2.14) | 1.16 (0.96-1.41) |
Diabetes
| 1.59 (1.28-1.98) | 1.27 (1.01-1.60) | 1.22 (0.86-1.75) | 1.15 (0.86-1.52) |
Arthritis
| 2.30 (1.92-2.75) | 1.79 (1.46-2.21) | 1.63 (1.33-1.98) | 1.16 (0.97 -1.40) |
Chronic Lung D
| 1.38 (0.99-1.93) | 1.02 (0.74-1.42) | 1.34 (0.90-2.02) | 1.06 (0.70-1.60) |
Stroke
| 1.87 (1.24-2.83) | 1.59 (1.05-2.42) | 3.53 (2.18-5.73) | 3.01 (1.86-4.87) |
Number of physical conditions
| ||||
1
| 1.67 (1.35-2.08) | 1.32 (1.07-1.63) | 1.63 (1.38-1.94) | 1.33 (1.13-1.57) |
2
| 1.95 (1.51-2.51) | 1.30 (1.00-1.67) | 2.06 (1.64-2.60) | 1.43 (1.13-1.81) |
≥3
| 2.83 (2.23-3.58) | 1.75 (1.38-2.23) | 2.64 (2.00-3.48) | 1.69 (1.27-2.24) |
Association between visual acuity and variables related to mental health and cognition
Depression (OR) | Depression (AOR) | Anxiety (OR) | Anxiety (AOR) | Cognition (OR) | Cognition (AOR) | |
---|---|---|---|---|---|---|
Distance VA
| 1.64 (1.27-2.12) | 1.25 (0.97-1.61) | 0.90 (0.47-1.71) | 0.74 (0.39-1.40) | 1.47 (1.17-1.86) | 1.27 (1.02-1.59) |
Near VA
| 1.39 (1.01-1.93) | 1.10 (0.78-1.53) | 0.97 (0.55-1.73) | 0.83 (0.43-1.64) | 1.72 (1.46-2.02) | 1.51 (1.28-1.85) |
Subjective distance VA
| 2.80 (2.10-3.74) | 1.61 (1.14-2.27) | 2.15 (1.14-4.04) | 1.47 (0.71-3.04) | 2.05 (1.44-2.90) | 1.43 (1.00-2.06) |
Subjective near VA
| 2.40 (1.74-3.30) | 1.48 (1.03-2.13) | 0.42 (0.09-1.93) | 0.27 (0.05-1.36) | 2.96 (1.92-4.55) | 2.40 (1.52-3.71) |