Purchase this article with an account.
D D. Zheng, Sharon L. Christ, David J. Lee, Byron L. Lam, Kristopher L. Arheart; Visual Impairment and Increased Mortality: The Effects of Mental Well-Being and Preventive Care. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4226.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Blindness and poor vision can have a detrimental impact on mental health. In the present study, we examine the relationship between vision, mental well-being, preventive care, and mortality by estimating the direct and indirect effects of self-rated visual impairment (VI) on mortality through mental well-being and preventive care.
Using complete data from 12,987 adult participants (≥ age 18 years) of the 2000 Medical Expenditure Panel Survey (MEPS) with mortality linkage through 2006, we undertook structural equation modeling employing two latent variables representing mental well-being and preventive care to examine the effects of self-rated VI on all-cause mortality (Model depicted in Figure). Generalized linear structural equation modeling (GSEM) was used to simultaneously estimate pathways including the latent variables and Cox regression model.
VI increases the risk of mortality directly after adjusting for mental well-being and preventive care status and other covariates. (HR=1.34; 95% CI: [1.15, 1.57]). Mental well-being and preventive care status both predict mortality (HR=1.58 [1.28, 1.95] and HR=3.58 [2.20, 5.81] respectively). VI adversely affects mental well-being (b= -0.16; p<0.001) but not preventive care practices (b= -0.03; p=0.35). VI increases mortality risk indirectly through mental well-being (HR= 1.07 [1.03, 1.12]). The total effect of VI on mortality including its influence through mental well-being is HR 1.44 [1.23, 1.68].
Visual impairment directly increases the risk of mortality and also indirectly increases mortality risk slightly through its adverse impact on mental well-being. The persistent increased mortality risk among the visually impaired documented across epidemiologic studies is not due to the impact of VI on reduced preventive care practices.
This PDF is available to Subscribers Only