Researchers from the University of Michigan conducted a study using data from the 2021 National Health and Aging Trends Study (NHATS) to assess national epidemiological rates of vision impairment (VI) in patients 71 years of age and older.
Give me some background on NHATS.
NHATS is a population-based, nationally representative panel study of Medicare beneficiaries 65 years and older. Patients in the study complete tablet-based tests of distance and near visual acuity and measured contrast sensitivity with habitual correction.
Tell me more.
Investigators analyzed data from 3,026 participants; 29.5% were 71 to 74 years old and 55.2% were female.(via)
How did the study measure visual impairment? ?
The research team measured presenting distance and near visual acuity (>0.30 logMAR, Snellen equivalent worse than 20/40) and contrast sensitivity (>1 SD below the sample mean).
Additional VI prevalence estimates were calculated by comparing participants’ age, socioeconomic status, and demographic data.
What were the findings?
The study found that the prevalence of VI in US patients 71 years and older was 27.8%, even while using corrective therapies such as glasses, contact lenses, or other visual aids.
Results also showed that 10.3% and 22.3% of participants had distance and near-visual acuity impairments, respectively. A 10% prevalence of contrast sensitivity impairments was noted in NHATS subjects.
Additionally, increased age, lower education level, and lower income were associated with all types of VI. A higher prevalence of near visual acuity and contrast sensitivity impairment was observed in non-Hispanic Black and Hispanic participants compared to non-Hispanic white participants.
What makes this study unique?
It presents the first nationally representative data using objective visual function testing in more than 14 years. In contrast, current measures of the prevalence of VI in the US are based on self-reported survey data or out-of-date visual function assessments.
Significance?
As Olivia J. Killeen, MD, MS, lead author of the study pointed out, poor vision is associated with several adverse outcomes for older adults, including depression, dementia, falls, motor vehicle accidents, and death.
Consistently checking in with older patients, measuring their visual acuity and contrast sensitivity, and treating VI aggressively can help to reduce progression.
On a wider scale, as elderly patients are at high risk for VI and blindness, it is essential that public health policies focus on making these treatments as accessible as possible.
One potential target is Medicare, as it currently does not cover eyeglass benefits unless a patient has had cataract surgery, which adds a financial burden to an already vulnerable patient population. (via)