Study Links Visual Impairment with Mortality

This analysis of a large database found a 21% higher mortality rate among individuals with self-reported visual impairment. Photo: CDC. Click image to enlarge. While visual impairment has been linked to higher mortality in older adults, previous research has suggested that severe impairment is associated with reduced physical activity, poor sleep quality and elevated rates of depressive symptoms, likely due to mobility limitations, disrupted circadian rhythms and increased social isolation. These lifestyle factors and mental health may be associated with increased mortality risk.Recently, researchers from China assessed a nationally representative cohort of older US adults from the 2007 to 2008 National Health and Nutrition Examination Survey data to determine that visual impairment was independently associated with a 21% increased risk of all-cause mortality, even after adjusting for sociodemographic clinical and lifestyle factors. The increased mortality risk appeared to be driven by subjective visual impairment reporting, while objective visual impairment measures alone may not substantially affect survival. Notably, reduced physical activity partially mediated the association between impairment and all-cause mortality (9.4% of the total effect), whereas depressive symptoms did not significantly mediate this relationship.This prospective cohort study, which was published in BMJ Open Ophthalmology, included adults aged 60 years and older. Visual impairment was defined as either subjective visual impairment based on self-reported vision status or objective visual impairment defined as presenting visual acuity worse than 20/40 in the better-seeing eye. Physical activity was assessed using a modified International Physical Activity Questionnaire, and depressive symptoms were assessed using the nine-item Patient Health Questionnaire. A total of 2,154 participants (mean age: 70.6; 44.2% male) were included.Over a median follow-up of 145 months, 399 (57.8%) deaths occurred in the visual impairment group and 535 (34.6%) in the non-impairment group. Visual impairment was associated with an increased risk of all-cause mortality after propensity score matching and multivariable adjustment (hazard risk; HR: 1.21). In subgroup analyses, subjective visual impairment was significantly associated with mortality (HR: 1.33), whereas objective impairment was not.The researchers proposed that brief self-reported vision questions and support to maintain physical activity may help identify and manage higher-risk older adults with visual impairment.“Subjective impairment encompasses not only reduced visual acuity but also a range of visual challenges, including impaired contrast sensitivity, restricted visual fields and limitations in vision-dependent daily activities,” the study authors wrote. Additionally, subjective visual impairment likely reflects non-visual factors, such as psychological perceptions of vision loss, reduced social engagement and decreased confidence in mobility, which collectively influence overall health status and mortality risk.”“These findings highlight the critical need for integrated strategies to promote physical activity tailored to visually impaired older adults, such as adaptive exercise programs and environmental modifications to enhance mobility safety,” they concluded. “Early identification of visual impairment, promotion of physical activity and preservation of functional capacity should be key priorities in public health strategies to support healthy aging.”Click here for the journal source. Luo Z, Lin Z, Xu Y, et al. Subjective and objective visual impairment and all-cause mortality in older US adults: the role of physical activity and depressive symptoms in NHANES 2007–2008. BMJ Open Ophthalmol. 226;11(2):e002744. 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.