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Senior Citizen Health & Medicine
Are You Dying of Poor Vision? Older People with
Cataracts or AMD at Higher Risk of Death
Unclear why theres link between visual problems and
death, maybe something not measured in this study
 July
9, 2007 Many senior citizens may be dying from poor eye sight. At
least that seems to be the case, according to a new study published in
the July issue of Archives of Ophthalmology, one of the JAMA/Archives
journals. This report says people age 49 and older with cataract and
those age 49 to 74 years with age-related macular degeneration appear to
have higher mortality rates over an 11-year period than those without
such visual impairments.
Several studies have shown associations between
visual problems and the risk of death in older individuals, according to
background information by the authors of the article.
But finding that the mechanisms for
higher mortality associated with visual impairment were unclear, they
began to search for the causes.
They considered, It could be attributed to age-related ocular
conditions, such as age-related macular degeneration (AMD) or cataract,
which can be markers of biological aging. Alternatively, visual
impairment and its related ocular conditions could share a similar
pathogenesis with other conditions associated with increased mortality.
Sudha Cugati, M.S., of the University of Sydney,
Australia, and colleagues assessed 3,654 individuals age 49 and older
who were part of the Blue Mountains Eye Study, an ongoing examination of
visual disorders in the Blue Mountains area west of Sydney.
When the participants enrolled in the study,
between 1992 and 1994, they were assessed for overall visual impairment
and its two main causes: cataract, a disease in which the eyes lens is
covered by a film that reduces sight, and ARMD, which occurs when the
macula, the area at the back of the retina that produces the sharpest
vision, deteriorates over time.
By Dec. 31, 2003 - an average of 11 years of
follow-up - 1,051 participants (28.9 percent) died.
Rates of death were higher among
● those with any visual impairment than among
those without (54 percent vs. 34 percent),
● among those with AMD than those without (45.8 percent vs. 33.7
percent) and
● among those with cataract than those without (39.2 percent vs. 29.5
percent).
After adjusting for factors that predict
mortality, neither visual impairment nor AMD was significantly
associated with all-cause mortality in all ages, the authors write.
Among persons younger than 75 years, however, ARMD
predicted higher all-cause mortality.
Among participants of all ages, having cataract
also was associated with a higher risk of death from any cause.
It remains unclear whether there is a direct or
indirect link between visual impairment and death or if another factor
not measured in this study affected the results, the authors note.
The implications of these findings also remain
uncertain: whether such an association indicates that visual impairment,
age-related eye disease or both are markers of aging and frailty or
whether these ocular conditions accelerate aging, thus leading to
relatively earlier death in older persons, they conclude.
If a direct or indirect causal effect from visual
impairment on earlier death is confirmed, regular assessment of vision
in older persons may lead to early detection, facilitating treatments
that could reduce the impact of visual impairment.
Editor's Note: This study was supported by grants
from the Australian National Health and Medical Research Council.
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