Clinical Interventions in Aging (May 2021)
Prevalence, Causes, and Factors Associated with Visual Impairment in a Chinese Elderly Population: The Rugao Longevity and Aging Study
Abstract
Hangqi Shen,1– 6,* Hui Zhang,7,8,* Wei Gong,1– 6 Tianwei Qian,1– 6 Tianyu Cheng,1– 6 Li Jin,7,8 Xiaofeng Wang,7– 10 Dawei Luo,1– 6 Xun Xu1– 6 1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China; 3Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China; 4Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, People’s Republic of China; 5National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China; 6Key Laboratory of Arrhythmias of the Ministry of Education of China, Tongji University School of Medicine, Shanghai, People’s Republic of China; 7Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, People’s Republic of China; 8Human Phenome Institute, Fudan University, Shanghai, People’s Republic of China; 9Shanghai Key Laboratory of Clinical Geriatric Medicine and Huadong Hospital Clinical Research Center for Geriatric Medicine, Shanghai, People’s Republic of China; 10National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dawei Luo; Xun XuDepartment of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of ChinaEmail [email protected]; [email protected]: This study aimed to explore the current prevalence, causes, and factors associated with visual impairment in a Chinese elderly population.Methods: A random sample of 2164 candidates aged ≥ 70 years was selected. Among them, 1914 participants (response rate: 88.4%) underwent comprehensive eye examinations. The prevalence and causes of visual impairment were estimated, and the associated factors were identified.Results: The standardized prevalence of mild visual impairment (< 6/12 to ≥ 6/18), moderate to severe visual impairment (MSVI) (< 6/18 to ≥ 3/60), and blindness (< 3/60) in the better eye were 20.5%, 25.8%, and 3.4%, respectively. The leading cause of visual impairment was cataract (49.7%), followed by uncorrected refractive error (26.5%), myopic maculopathy (5.8%), and posterior capsular opacification (5.5%). Optical coherence tomography revealed that vitreoretinal interface abnormalities were the third most common cause of monocular mild visual impairment (2.2%) and MSVI (4.4%) in the elderly population. A large number of patients with visual impairment (81.7%) were amenable to undergo the interventions. Visual impairment was associated with advanced age (odds ratio [OR], 1.09 per year; p< 0.001), female sex (OR, 1.59; p=0.003), self-reported visual impairment (OR, 1.91; p< 0.001), cognitive impairment (OR, 1.40, p=0.005), and high educational level (OR, 0.75; primary, p=0.045; and OR, 0.53, secondary or higher; p< 0.001).Conclusion: Visual impairment was common in the Chinese elderly population and a severe health and social problem. Practicable policies are urgently needed to popularize eye health knowledge and promote treatments for visual impairment in elderly people in rural China.Keywords: visual impairment, blindness, elderly, aging