Age and Ageing, Vol 29, 335-339, Copyright © 2000 by British Geriatrics Society
A Sinclair, A Bayer, A Girling and K Woodhouse
Main objectives: to screen for impaired distance
visual acuity in older adults living at home, both with and without
diabetes mellitus to determine whether diabetes increase the likelihood of
visual impairment and to identify associated
factors.Design: case-control
study.Settings: three districts of Wales: North Clwyd,
Powys and South Glamorgan, with assessments in subjects'
homes.Subjects: 385 with diabetes mellitus and 385
age- and sex-matched controls.Main outcome measures:
visual acuity measures, short form (SF)-36 quality of life
scores.Results: we observed impairment of visual
acuity in 40% of those with diabetes mellitus and 31% of controls. Diabetes
was associated with an increased risk of visual impairment [odds ratio 1.50
(95% confidence interval 1.09-2.05), P = 0.013]. The
pinhole test identified uncorrected refractive error in 11% of the 63
patients with diabetes and 12% of the 49 controls who wore glasses, and in
51% of the 91 patients and 84% of the 69 controls who did not wear glasses
(P < 0.001). Increasing age
(P < 0.001) and female sex
(P = 0.014) were significantly associated with visual
impairment in both groups, whilst history of foot ulceration
(P = 0.001), duration of diabetes
(P = 0.018) and treatment with insulin
(P < 0.001) were significantly associated with
visual impairment in subjects with diabetes. We observed a significant
association between impaired visual acuity and five domains of the SF-36
(physical and social functioning, mental health, vitality, and health
perceptions; P < 0.01 in each
case).Conclusions: older adults living at home have a
high prevalence of uncorrected visual impairment. Diabetes mellitus is
associated with significantly increased risk of visual loss. This
impairment is associated with detriments in health-related quality of life.
We recommend earlier use of optometry services and assessment of visual
acuity by clinicians.Keywords: aged, diabetes
mellitus, quality of life, visual acuity
ARTICLES
Older adults, diabetes mellitus and visual acuity: a community-based case-control study
Academic Department of Geriatric Medicine and Gerontology, Hayward Building, Selly Oak Hospital, Birmingham B29 6JD, UK; University Department of Geriatric Medicine, University of Wales College of Medicine, Llandough Hospital, Penarth, UK; Department of Mathematics and Statistics, University of Birmingham, Birmingham UK; Corresponding author; e-mail: a.j.sinclair@bham.ac.uk
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