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Multicenter Study
. 2010 Jan;149(1):160-9.
doi: 10.1016/j.ajo.2009.07.025. Epub 2009 Oct 1.

The association of smoking and alcohol use with age-related macular degeneration in the oldest old: the Study of Osteoporotic Fractures

Anne L Coleman  1 , Robin L Seitzman, Steven R Cummings, Fei Yu, Jane A Cauley, Kristine E Ensrud, Katie L Stone, Marc C Hochberg, Kathryn L Pedula, Edgar L Thomas, Carol M Mangione; Study Of Osteoporotic Fractures Research Group
Collaborators, Affiliations
Multicenter Study

The association of smoking and alcohol use with age-related macular degeneration in the oldest old: the Study of Osteoporotic Fractures

Anne L Coleman et al. Am J Ophthalmol. 2010 Jan.

Abstract

Purpose: To estimate the incidence of age-related macular degeneration (AMD) and the association of smoking and alcohol in a population of older women.

Design: Prospective cohort study.

Methods: Subjects were women who attended the Study of Osteoporotic Fractures year-10 and year-15 follow-up clinic visits and had fundus photographs taken at both visits (n = 1958; 245 Black and 1713 White subjects; mean age at year 10 visit, 78.2 years). Forty-five degree stereoscopic fundus photographs were graded for AMD. Logistic regression was used to test whether risk factors were associated with incident AMD.

Results: The overall 5-year AMD incidence was 24.1% (95% confidence interval [CI], 21.7 to 26.6) for early and 5.7% (95% CI, 4.6 to 6.8) for late. Early AMD incidence in White subjects ranged from 21.9% in those aged 74 to 79 years to 33.2% in those 80 to 84 years, but was observed at the slightly lower rate of 29.0% in subjects > or =85 years (trend P < .0001). After confounder adjustment, alcohol consumption was significantly associated with an elevated risk of incident early AMD (odds ratio [OR], 1.57; 95% CI, 1.18 to 2.11). There was an increased risk of early AMD among subjects aged 80 years or older who were smoking compared to those younger than 80 years who were not smoking (OR, 5.49; 95% CI, 1.57 to 19.20; P for interaction = .026).

Conclusions: The magnitude of the greater-than-additive effect of smoking on the age-adjusted risk of AMD reinforces recommendations to quit smoking even for older individuals.

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Figures

Figure 1
Figure 1
Flow chart of participants in the study of incidence of age-related macular degeneration (IAMD) of the Study of Osteoporotic Fractures (SOF).
Figure 2
Figure 2
Age-related macular degeneration (AMD) 6-level severity scale used in the study of incidence of age-related macular degeneration (IAMD) of the Study of Osteoporotic Fractures (SOF). RPE=Retinal pigment epithelium No AMD = level 10 or 20 in both eyes Early AMD = level 30 or 40 in at least one eye, but neither levels 50 or 60 in either eye Late AMD = level 50 or 60 in at least one eye
Figure 3
Figure 3
Effects of interaction between age at year 10 and smoking history on risk for incident early age-related macular degeneration (AMD) in the study of incidence of age-related macular degeneration (IAMD) of the Study of Osteoporotic Fractures (SOF). (P-value for interaction=0.026).
See this image and copyright information in PMC

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