Visual impairment and multimorbidity in a representative sample of the Spanish population

BMC Public Health

Research Article

Marta Miret¹  Jose Luis Ayuso-Mateos²  Maria Victoria Moneta³  Beatriz Olaya⁴  Josep Maria Haro⁴  Noe Garin⁴  Elvira Lara⁵ 

[1]Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón, 11 28029, Madrid, Spain

[2]Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo s/n, 28029, Madrid, Spain

[3]Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón, 11 28029, Madrid, Spain

[4]Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo s/n, 28029, Madrid, Spain

[5]Instituto de Investigación Sanitaria Princesa (IP), Diego de León, 62, 28006, Madrid, Spain

[6]Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr Antoni Pujades, 42, 08830, Barcelona, Sant Boi de Llobregat, Spain

[7]Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr Antoni Pujades, 42, 08830, Barcelona, Sant Boi de Llobregat, Spain

[8]Fundació Sant Joan de Déu, 39-57, 08950, Barcelona, Santa Rosa, Esplugues de Llobregat, Spain

[9]Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón, 11 28029, Madrid, Spain

[10]Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr Antoni Pujades, 42, 08830, Barcelona, Sant Boi de Llobregat, Spain

[11]Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón, 11 28029, Madrid, Spain

关键词: Epidemiology;    Chronic conditions;    Multimorbidity;    Visual impairment;    Low vision;    Mental health;    Cognitive functioning;    Elderly;   

DOI  :  10.1186/1471-2458-14-815

 received in 2014-04-02, accepted in 2014-06-26,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundIn the context of population aging, visual impairment has emerged as a growing concern in public health. However, there is a need for further research into the relationship between visual impairment and chronic medical conditions in the elderly. The aim of our study was to examine the relationship between visual impairment and three main types of co-morbidity: chronic physical conditions (both at an independent and additive level), mental health and cognitive functioning.MethodsData were collected from the COURAGE in Europe project, a cross-sectional study. A total of 4,583 participants from Spain were included. Diagnosis of chronic medical conditions included self-reported medical diagnosis and symptomatic algorithms. Depression and anxiety were assessed using CIDI algorithms. Visual assessment included objective distance/near visual acuity and subjective visual performance. Descriptive analyses included the whole sample (n = 4,583). Statistical analyses included participants aged over 50 years (n = 3,625; mean age = 66.45 years) since they have a significant prevalence of chronic conditions and visual impairment. Crude and adjusted binary logistic regressions were performed to identify independent associations between visual impairment and chronic medical conditions, physical multimorbidity and mental conditions. Covariates included age, gender, marital status, education level, employment status and urbanicity.ResultsThe number of chronic physical conditions was found to be associated with poorer results in both distance and near visual acuity [OR 1.75 (CI 1.38-2.23); OR 1.69 (CI 1.27-2.24)]. At an independent level, arthritis, stroke and diabetes were associated with poorer distance visual acuity results after adjusting for covariates [OR 1.79 (CI 1.46-2.21); OR 1.59 (CI 1.05-2.42); OR 1.27 (1.01-1.60)]. Only stroke was associated with near visual impairment [OR 3.01 (CI 1.86-4.87)]. With regard to mental health, poor subjective visual acuity was associated with depression [OR 1.61 (CI 1.14-2.27); OR 1.48 (CI 1.03-2.13)]. Both objective and subjective poor distance and near visual acuity were associated with worse cognitive functioning.ConclusionsArthritis, stroke and the co-occurrence of various chronic physical diseases are associated with higher prevalence of visual impairment. Visual impairment is associated with higher prevalence of depression and poorer cognitive function results. There is a need to implement patient-centered care involving special visual assessment in these cases.

【 授权许可】

Unknown   
© Garin et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.