Abstract
Purpose :
Vision impairment (VI) is associated with anxiety in older adults. However, few nationally-representative US data sources describe this relationship across a broad range of adult ages, and none examine the association of co-occurring VI and chronic diseases with anxiety. Using cross-sectional, nationally-representative household survey data, we describe the relationship between VI and psychological distress in US adults aged ≥40 years and examine effect modification of this relationship by the presence of chronic diseases (diabetes, hypertension, arthritis, coronary heart disease, chronic obstructive pulmonary disease (COPD), myocardial infarction, or stroke).
Methods :
Data are from the 2016 and 2017 National Health Interview Survey of US noninstitutionalized civilians; all variables are self-reported. The analytic sample included 39,005 adults aged ≥40 years with data on VI and psychological distress. A two-part model evaluated the relationship between VI and Kessler Psychological Distress Scale (K6) scores. Effect measures were predicted average marginal K6 scores for the three-way interaction term that included age, VI, and each chronic disease, adjusting for sociodemographic characteristics and accounting for the complex survey design.
Results :
Participants’ average age was 59.0 years (95% CI: 58.8, 59.2); 52.5% (CI: 51.9, 53.2) were female; 13.0% (CI: 12.5, 13.5) had VI; chronic disease prevalence ranged from 4.7% (CI: 4.4, 5.0) with a stroke to 44.0% (CI: 43.2, 44.8) having hypertension. Across all ages, those with VI had significantly higher mean K6 scores than those without VI (Figure 1). For arthritis and COPD, across a wide range of ages, those with both VI and the chronic disease had significantly higher mean K6 scores than those with only VI, only the chronic disease, or neither condition; this was true for hypertension and stroke across a narrower range of ages. For example, at 45 years, mean K6 scores were 6.9 (CI: 6.4, 7.4) [VI and arthritis], 5.1 (CI: 4.6, 5.5) [VI], 3.9 (CI: 3.7, 4.1) [arthritis], and 2.7 (CI: 2.6, 2.8) [neither].
Conclusions :
Adults with VI had higher psychological distress than those without VI, and for certain chronic diseases, having a comorbid chronic disease modified this effect. Interventions are needed to screen for and address psychological distress among people with VI, with and without comorbid chronic disease.
This is a 2020 ARVO Annual Meeting abstract.