Worsening Vision Associated with Depression, Diabetes, Heart Disease

One in five US adults 45 years old and above reported at least some vision difficulty and rates were linked with the presence of several systemic diseases. For example, the adjusted prevalence of hypertension was 32.9% among those with no vision difficulty but 47.8% among those with severe vision difficulty. Photo: Getty Images. Click image to enlarge. Eye diseases and vision loss can be related to chronic health conditions in a variety of ways, as they can be both a risk factor for and outcome of other such systemic diseases. In a recent study, researchers examined the association between self-reported vision difficulty and the prevalence of 11 chronic health conditions among adults aged 45 and older in the United States using 2020 to 2024 National Health Interview Survey (NHIS) data. They found that middle-aged and older adults with vision difficulties, whether some or severe, had a higher prevalence of depression, diabetes, heart disease, kidney failure and stroke. The findings were reported in American Journal of Ophthalmology.A total of 85,206 individuals were included. Conditions included self-reported hypertension, heart disease, high cholesterol, stroke, arthritis, cancer, weak/failing kidneys, dementia, diabetes, depression and obesity. Adjusted prevalence ratios were estimated using multivariable logistic regression models for each condition by vision difficulty status (none, some, severe) stratified by age group (45 to 64, ≥65 years).Overall, 20.2% of adults aged 45+ reported some vision difficulty and 2.1% reported severe vision difficulty. The prevalence of most chronic diseases examined was greater among adults with vision difficulties, whether some or severe, and that the prevalence of some self-reported chronic health conditions (eight among those aged 45 and 64 years and five among those aged ≥64 years) increased with worsening vision difficulty. “Some and severe vision difficulty may reflect distinct constructs, with some vision difficulty potentially indicating less severe or earlier-stage eye disease and severe vision difficulty reflecting more advanced disease, prior eye injury or unmet needs related to detection and access to complex treatment,” the authors wrote in their paper.Among both middle-aged (between ages 45 and 64) and older (≥65) adults, having vision difficulty was generally associated with a higher prevalence of chronic conditions compared to those without.Worsening vision difficulty (from none to some to severe) correlated with an increased prevalence of depression, diabetes, heart disease, kidney failure and stroke in both age groups. In middle-aged adults, this upward trend was also observed for hypertension, high cholesterol and arthritis. Dementia prevalence increased with worsening vision difficulty among older adults.Even after adjusting for sociodemographic and health-related factors, individuals with vision difficulty consistently showed higher prevalence ratios for most examined conditions compared to those with no vision difficulty.“Our findings suggest that incorporating vision health within chronic disease prevention and management strategies earlier in the life course may be especially impactful, while also ensuring that older adults with vision difficulty receive comprehensive care and support,” the researchers wrote in their paper.For example, vision screening may be a helpful way to identify adults at risk of developing chronic conditions or for early detection of chronic conditions, while addressing vision difficulty among those with existing chronic diseases may support disease management and improve quality of life. “Eye care visits offer important opportunities to detect conditions like diabetes and hypertension, which may initially present with ocular symptoms, and integrate patients into the healthcare system,” the authors concluded.Click here for the journal source. Choi JHS, Carlson SA, Pavkov ME, et al. Prevalence of chronic health conditions by vision difficulty status among middle-aged and older adults, United States, 2020-2024. Amer J Ophthalmol. May 18, 2026. [Epub ahead of print.]This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.