Abstract
Abstract: :
Purpose: To determine if visual acuity (VA) and/or contrast sensitivity (CS) are independent risk factors for mortality in older women. Methods: During the baseline examination (8/92-6/94), we assessed visual acuity using Bailey-Lovie charts and contrast sensitivity using Vistech charts in 9,067 postmenopausal women aged 65 years and older. We also obtained measures and self-reported histories of other mortality risk factors. Vital status was updated every 4 months over an average follow-up of 1l.3 years. Death certificates were physician adjudicated to confirm primary cause of death. We used proportional hazards models to assess the independent contribution of visual acuity and contrast sensitivity to mortality after adjusting for other known risk factors. Results: Mortality rates were significantly higher in persons with VA 20/40 or worse vs those with better than 20/40 VA (50 vs 31%, p<0.001). Mortality by LogMar VA ranged from 21% in the lowest (<0.02) quartile to 48% in the highest (≷0.2) quartile (p<0.001). Mortality by average CS ranged from 20% in the best (≷77) CS quartile to 49% in the poorest(<33) CS quartile (p<0.001). On multivariate analysis, LogMar VA and average CS remained independent predictors of non-traumatic and all-cause mortality. For each quartile of poorer LogMar VA, mortality increased by 5% (p=0.03); for each quartile of poorer CS, mortality increased by 14% (p<0.001). CS was also a strong predictor of traumatic mortality (p<0.001) Conclusion: Women with poorer visual acuity and contrast sensitivity have an increased mortality rate, even after adjusting for other known risk factors. The mechanisms behind these relationships require further investigation.
Keywords: 353 clinical (human) or epidemiologic studies: outcomes/complications • 368 contrast sensitivity • 620 visual acuity