Abstract
Purpose: :
To assess the prevalence trends for three major age-related eye diseases (age-related macular degeneration, cataract, and glaucoma) among nursing home residents and to explore the relationship between these eye diseases and residents’ visual function as reported by nursing home staff.
Methods: :
This study utilizes National Nursing Home Survey (NNHS) trend data for survey years 1995-2004. We used SAS version 9.1 and SUDDAN version 9.0 to control for complex sample design and non-response. Cases of age-related macular degeneration (ARMD), current cataract, and glaucoma were identified using ICD-9 codes. We assessed changes of prevalence using t-test and the linear trend by applying weighted least squares regression. We calculated odds ratio and 95% confidence intervals for the association between eye diseases and staff-reported visual function.
Results: :
The estimated trends in prevalence of each of the eye diseases from 1995 to 2004 were: ARMD, 0.93 to 2.28% (p trend <0.001); cataract, 3.75 to 2.47% (p trend =0.03); glaucoma, 5.32 to 5.06% (p trend=0.86). Among nursing home residents with ARMD, the weighted trend significantly increased over the study period in the 75-84 and 85+ year old groups, and among whites. Odds ratios for staff-reported visual function impairment were higher for residents with diagnosed eye diseases than for those without eye disease (ARMD OR= 5.79; cataract OR= 2.33; glaucoma OR= 2.98).
Conclusions: :
The weighted population trends in three major age-related eye diseases in nursing home residents varied during the study period. The prevalence of ARMD increased over time, while the prevalence of cataracts decreased and the prevalence of glaucoma remained relatively stable. Trends also varied by age and race. Nursing home staff were more likely to report impaired visual function in residents with diagnosed eye diseases. Recognition of residents’ visual impairment by nursing home staff is important because if staff do not recognize visual impairment then it is unlikely they will alert anyone to the need for referring residents for further evaluation. Visual impairment in this population can lead to increased risk for falls and reduced quality of life.
Keywords: aging • aging: visual performance • quality of life