Abstract
Abstract: :
Purpose: Associations between visual impairment, eye disease and mortality due to unintentional injuries have not been extensively studied, due, in part, to the low proportion of mortality attributed to falls, motor vehicle crashes and other injuries (∼4%). This study examines associations between self-reported visual impairment, selected eye diseases and mortality due to unintentional injuries in a nationally representative sample of community-residing adults. Methods: Mortality linkage with over 96% of participants from the 1986-1994 National Health Interview Survey was performed by the National Center for Health Statistics through December 31, 1995. Complete data were available on 117,157 adults 18 years of age and older. Participants were asked if they or a family member had visual impairment, cataract, retinopathy and glaucoma. Unintentional injury deaths included ICD-9 codes E800-E949 (e.g., transportation accidents, poisoning, falls, drowning). Analytical methods included Cox regression models with adjustments for age and gender as well as the complex sample survey design. Results: Mortality linkage identified 190 unintentional injury deaths; the average number of years of follow-up was 5.2 years. Controlling for survey design, age, gender and cataract, retinopathy and glaucoma, participants with some visual impairment were not at significantly increased risk of unintentional death relative to participants not reporting visual impairment (Hazard Ratio, HR= 1.30, 95% CI: [0.60-2.84]). However, in the same multivariate model, participants with severe, bilateral visual impairment were at increased risk of unintentional death relative to participants without visual impairment (5.80 [1.74, 19.28]). There were no significant associations between cataract, retinopathy, glaucoma and unintentional injury mortality. Conclusion: Severe, bilateral visual impairment is associated with an increased risk of unintentional injury mortality among adults residing in the United States.