Incidence Patterns of Presenting Visual Impairment among U.S. Older Adults

Abstract

Purpose : No nationally representative data exist on the rate of new onset vision impairment (VI) in the U.S. This study aims to investigate one-year incidence patterns of VI among older adults in the U.S.

Methods : Data from Rounds 11-12 of the National Health and Aging Trends Study (NHATS), collected in 2021 and 2022, were used. NHATS, a nationally representative panel study, includes validated tablet-based measures of presenting binocular visual acuity (both distance and near) and contrast sensitivity (CS) that are administered annually. Incidence rates were examined along with patterns of spectacle use at Rounds 11 and 12. All analyses accounted for NHATS complex survey design to make nationally representative estimates.

Results : Among the 2,538 participants, all were 71 or older in 2021. The average 1-year change in distance vision was logMAR (SE) +0.0105 (0.0065), for near vision was +0.0149 (0.0045), and for contrast sensitivity was logCS (SE) -0.0185 (0.0063). The net prevalence change from 2021 to 2022 was +1.37%, +2.09%, and +1.23% for moderate or worse distance VI, near VI, and CS impairment, respectively. The incidence proportion rate (95% CI) was 3.5% (6.4, 10.3), 14.3% (12.5, 16.0), and 5.5% (4.1, 6.8) for moderate or worse distance VI, near VI, and CS impairment, respectively. The difference between incidence proportion rates and the net prevalence change was accounted for by improved vision in some participants. Spectacle wear in Rounds 11 and 12 influenced the likelihood of experiencing incident impairment or improved vision.

Conclusions : Patterns of VI are complex in older adults, with many experiencing year-to-year worsening or improvement, partly explained by spectacle use. Optimizing vision in later life is important for maintaining high quality of life, wellbeing, and preventing VI-associated disability. Interventions to optimize vision should be prioritized, including provision of spectacles.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.