Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar:235:163-171.
doi: 10.1016/j.ajo.2021.09.004. Epub 2021 Sep 20.

Longitudinal Associations Between Vision Impairment and the Incidence of Neuropsychiatric, Musculoskeletal, and Cardiometabolic Chronic Diseases

Ajay Kolli  1 , Kristian Seiler  2 , Neil Kamdar  3 , Lindsey B De Lott  4 , Mark D Peterson  5 , Michelle A Meade  5 , Joshua R Ehrlich  6
Affiliations

Longitudinal Associations Between Vision Impairment and the Incidence of Neuropsychiatric, Musculoskeletal, and Cardiometabolic Chronic Diseases

Ajay Kolli et al. Am J Ophthalmol. 2022 Mar.

Abstract

Purpose: To compare the incidence and hazard of neuropsychiatric, musculoskeletal, and cardiometabolic conditions among adults with and without vision impairment (VI).

Design: Retrospective cohort study.

Methods: The sample comprised enrollees in a large private health insurance provider in the United States, including 24 657 adults aged ≥18 years with VI and age- and sex-matched controls. The exposure variable, VI, was based on low vision and blindness International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM), diagnosis codes. Physician-diagnosed incident neuropsychiatric, musculoskeletal, and cardiometabolic diseases were identified using ICD codes. Separate Cox proportional hazards regression models were used to assess the association of VI with incidence of 30 chronic conditions, adjusting for Elixhauser Comorbidity Index. Analyses were stratified by age 18-64 years and ≥65 years.

Results: In individuals with VI aged 18-64 years (n=7478), the adjusted hazard of neuropsychiatric (HR 2.1, 95% CI 1.9, 2.4), musculoskeletal (HR 1.8, 95% CI 1.7, 2.0), and cardiometabolic (HR 1.8, 95% CI 1.7, 2.0) diseases was significantly greater than in matched controls (mean 5.5 years follow-up). Similar associations were seen between patients with VI aged ≥65 years (n=17 179) for neuropsychiatric (HR 2.4, 95% CI 2.1, 2.7), musculoskeletal (HR 1.8, 95% CI 1.6, 1.9), and cardiometabolic (HR 1.7, 95% CI 1.4, 2.0) diseases. VI was associated with a higher hazard of each of the 30 conditions we assessed, with similar results in both age cohorts.

Conclusion: Across the life span, adults with VI had an approximately 2-fold greater adjusted hazard for common neuropsychiatric, musculoskeletal, and cardiometabolic disorders compared with matched controls without VI.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: NK maintains financial interest and consults for Lucent Surgical. No other author has any commercial, proprietary, or financial interest in any of the products or companies described in this article.

Figures

Figure 1:
Figure 1:
Sample Selection of 24,657 Adults with Vision Impairment and 24,657 Age- and Sex-Matched Controls.
Figure 2:
Figure 2:. Kaplan-Meier Survival Curves for Incident Neuropsychiatric, Musculoskeletal, and Cardiometabolic Disease in Individuals with (blue) & without (red) Vision Impairment.
Panel A: Neuropsychiatric Disease Panel B: Musculoskeletal Disease Panel C: Cardiometabolic Disease Shaded areas are 95% Hall-Wellner Bands. Between group difference was statistically significant for incident neuropsychiatric, musculoskeletal, and cardiometabolic disease (p<0.0001 for each by Log Rank Test).
Figure 3:
Figure 3:
Conceptual Model of the Relationship Between Vision Impairment and Other Chronic Conditions
See this image and copyright information in PMC

References

    1. GBD 2019 Blindness and Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study. Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021;9(2):el30–el43. doi:10.1016/S2214-109X(20)30425-3 - DOI - PMC - PubMed
    1. Rek M, Atl G, Ek F, et al. The Differential Impact of Age on Vision-Related Quality of Life across the Visual Impairment Spectrum. Ophthalmology. Published online July 29, 2020. doi: 10.1016/j.ophtha.2020.07.046 - DOI - PubMed
    1. Mangione CM. Psychometric Properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). Arch Ophthalmol. 1998;116(11):1496. doi: 10.1001/archopht.l16.11.1496 - DOI - PubMed
    1. Crews JE, Chou C-F, Sekar S, Saaddine JB. The Prevalence of Chronic Conditions and Poor Health Among People With and Without Vision Impairment, Aged ≥65 Years, 2010–2014. Am J Ophthalmol. 2017;182:18–30. doi:10.1016/j.ajo.2017.06.038 - DOI - PubMed
    1. Tran EM, Stefanick ML, Henderson VW, et al. Association of Visual Impairment With Risk of Incident Dementia in a Women’s Health Initiative Population. JAMA Ophthalmol. 2020;138(6):624. doi: 10.1001/jamaophthalmol.2020.0959 - DOI - PMC - PubMed

Publication types