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Jie Jin Wang, Paul Mitchell, Wayne Smith; Vision and Low Self-Rated Health: The Blue Mountains Eye Study. Invest. Ophthalmol. Vis. Sci. 2000;41(1):49-54.
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purpose. To assess the relationship between reduced vision and low self-rating
of global health, after taking into account many other related factors.
methods. The Blue Mountains Eye Study examined 3654 residents aged ≥49 years
(82.4% response) in an area west of Sydney, Australia. Presenting and
best-corrected visual acuity (VA) were measured before and after
refraction using a LogMAR chart. During a face-to-face interview,
self-rated health was assessed by asking: “For someone of your age,
how would you rate your overall health?: excellent, good, fair, or
poor.” Information about demography, socioeconomic status, need for
assistance in daily living activities, medical history, and health risk
behaviors was also collected. Logistic regression analyses were
performed after dichotomizing self-rated health as poor or fair (low)
versus good or excellent.
results. Among persons without visual impairment (defined from best-corrected VA
in the better eye), 24.5% rated their health as either poor or fair,
compared with 35.5% and 48.8% of persons with mild or
moderate-to-severe visual impairment, respectively. In multivariate
logistic regression models that included 17 other related factors,
reduced vision was statistically significantly associated with lower
self-rated health in persons aged <80 years. For each one-line (5
letter) reduction in best-corrected VA, there was 20% increased
likelihood of low self-rated health, after adjustment for other factors
found associated with self-rated health (multivariate-adjusted odds
ratio 1.2, 95% confidence interval 1.1–1.3). In persons aged 80 years
or older, reduced vision had no impact on global health rating.
conclusions. Decreased vision was found to have an independent impact on global
health ranking by persons younger than age 80 years, but not by older
persons in this population. Taking into account many other factors
affecting perceived health, people younger than age 80 years who see
well are also more likely to say that they feel
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