Abstract
Abstract: :
Purpose: To assess the association between self-reported cataract and mortality in a nationally representative sample of community residing US adults with visual impairment (VI) and those without VI. Method: Data for the present study were derived from the National Health Interview Survey (NHIS), and the Mortality Follow Up. The NHIS is a multipurpose household survey of the US civilian, non-institutionalized population, conducted annually since 1957. The Mortality Follow Up, is a mortality linkage through December 31, 1995, recently conducted by NCHS, with over 96% of participants from the 1986-94 NHIS. Analyses were performed separately for participants with cataract but no VI, and those with cataract and VI. Analytical techniques included Cox regression models with adjustments for the complex sampling design effect, as well as for age, gender, race, marital status, education level and self-rated health. Results: Complete data were available on 117788 adults 18 years of age and older with an average follow-up of 5.2 years, and included 113826 participants with no cataract (96.6%), 3359 with cataract but no VI (2.9%), and 603 with both cataract and VI (0.5%). The number of deaths in these three groups were 5360, 698, and 160, respectively. The following Table shows mortality Hazard Ratio estimates (HR) and the corresponding 95% Confidence Intervals [CI] for the Cataract-No VI group, as well as for the Cataract and VI group. The "Unadjusted HR's' refer to HR's after adjusting only for the effect of the complex survey design. The "Adjusted HR's' refer to HR's after further adjusting for age, gender, race, marital status, education level and self-rated health *CVD = Cardiovascular Disease (ICD-9: 390 - 448); **Cancer (ICD-9: 140 - 239) Conclusion: Self-reported cataract is associated with a higher risk of mortality among adults residing in the US. The risk is highest for those with visual impairment and, after adjustment for multiple covariates, the results remain statistically significant for all-cause mortality , as well as for CVD mortality.
Keywords: 338 cataract • 625 visual impairment: neuro-ophthalmological disease