Skip to main content
SpringerLink
Log in

Disability and 6-year mortality in elderly population. Role of visual impairment

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: We investigated the prevalence of visual impairment (VI), its determinants and its association with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Gross Mobility (GM) and 6- year mortality in elderly subjects. A cross-sectional survey in a large population randomly selected in 1992 with a 6-year mortality evaluation in Campania, a region in southern Italy. Methods: A random sample of 1332 elderly subjects aged 65 to 95 years (mean age 74.2±6.4), selected from the electoral rolls, was interviewed by trained physicians. Self-reported visual function, socio-demographic and clinical characteristics were recorded. Disability was assessed by measuring ability in ADL, IADL and GM. Results: VI was found to affect 34% of this population, with an age-related increase of mild and severe VI. VI affects ADL, IADL and GM disability. Age, diabetes and low educational level, but not comorbidity or hypertension, proved to be predictors of VI. Mortality increased with severity of VI in 38.1% of subjects with severe functional impairment (p<0.001). The presence of VI was seen to increase the risk of mortality by 1.40 (95% CI 1.07–1.84), independently of age, sex, comorbidity, diabetes, hypertension or disability. Conclusions: This study demonstrates an association between visual impairment and disability in an elderly population, and the predictive effect of visual impairment on mortality independently of comorbidity. These results illustrate the need to eradicate avoidable blindness, in order to improve the quality of life and to prolong survival of the elderly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hirvela H, Laatikainen L. Visual acuity in a population aged 70 years or older; prevalence and causes of visual impairment. Acta Ophthalmol Scand 1995; 73: 99–104.

    Article  PubMed  CAS  Google Scholar 

  2. Tielsch JM, Sommer A, Witt K, Katz J, Royall RM. Blindness and visual impairment in an American urban population. The Baltimore Eye Survey. Arch Ophthalmol 1990; 108: 286–90.

    Article  CAS  Google Scholar 

  3. Tielsch JM, Sommer A, Katz J, Quigley H, Ezrine S. Socioeconomic status and visual impairment among urban Americans. Baltimore Eye Survey Research Group. Arch Ophthalmol 1991; 109: 637–41.

    CAS  Google Scholar 

  4. Tielsch JM, Javitt JC, Coleman A, Katz J, Sommer A. The prevalence of blindness and visual impairment among nursing home residents in Baltimore. N Engl J Med 1995; 332: 1205–9.

    Article  PubMed  CAS  Google Scholar 

  5. Klein R, Klein BE, Moss SE. Age-related eye disease and survival. The Beaver Dam Eye Study. Arch Ophthalmol 1995; 113: 333–9.

    Article  CAS  Google Scholar 

  6. Klein R, Klein BE, Moss SE, Cruickshanks KJ. Association of ocular disease and mortality in a diabetic population. Arch Ophthalmol 1999; 117: 1487–95.

    Article  PubMed  CAS  Google Scholar 

  7. McCarty CA, Nanjan MB, Taylor HR. Vision impairment predicts 5 years mortality. Br J Ophthalmol 2001; 85: 322–6.

    Article  PubMed  CAS  Google Scholar 

  8. Wang JJ, Mitchell P, Simpson JM, Cumming RG, Smith W. Visual impairment, age-related cataract, and mortality. Arch Ophthalmol 2001; 119: 1186–90.

    Article  PubMed  CAS  Google Scholar 

  9. West GC, Gildengorin G, Haegerstrom-Portnoy OD, Schneck ME, Lott L, Brabyn JA. Is vision function related to physical functional ability in older adults? J am Geriatr Soc 2002; 50: 136–45.

    Article  PubMed  Google Scholar 

  10. Salive ME, Guralnik J, Glynn RJ, Christen W, Wallace RB, Ostfeld AM. Association of visual impairment with mobility and physical function. J Am Geriatr Soc 1994; 42: 287–92.

    PubMed  CAS  Google Scholar 

  11. Rubin GS, Roche KB, Prasado-Rao P, Fried LP. Visual impairment and disability in older adults. Optom Vis Sci 1994; 71: 750–60.

    Article  PubMed  CAS  Google Scholar 

  12. Reuben DB, Mui S, Damesyn M, Moore AA, Greendale GA. The prognostic value of sensory impairment in older persons. J Am Geriatr Soc 1999; 47: 930–5.

    PubMed  CAS  Google Scholar 

  13. Rovner BW, Ganguli M. Depression and disability associated with impaired vision: the MoVies project. J Am Geriatr Soc 1998; 46: 617–9.

    PubMed  CAS  Google Scholar 

  14. Brody BL, Gamst AC, Williams RA, et al. Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophtalmology 2001; 108: 1893–901.

    Article  CAS  Google Scholar 

  15. Cacciatore F, Gallo C, Ferrara N, et al. Morbidity patterns in an aged population in Southern Italy: a survey sampling. Arch Gerontol Geriatr 1998; 26: 201–13.

    Article  PubMed  CAS  Google Scholar 

  16. Cacciatore F, Abete P, Ferrara N, et al. The role of blood pressure in cognitive impairment in an elderly population. J Hypertens 1997; 15: 135–42.

    Article  PubMed  CAS  Google Scholar 

  17. Cacciatore F, Abete P, Ferrara N, et al. Congestive heart failure and cognitive impairment in an older population. Osservatorio Geriatrico Campano Study Group. J Am Geriatr Soc 1998; 46: 1343–8.

    CAS  Google Scholar 

  18. Cacciatore F, Napoli C, Abete P, Marciano E, Triassi M, Rengo F. Quality of life determinants and hearing function in an elderly population. Results from a cross-sectional study. Gerontology 1999; 45: 323–8.

    CAS  Google Scholar 

  19. Feller BA. Prevalence of selected impairments, US, 1977 Vital and Health Statistics Department of Health and Human Services, National Center for Health Statistics, DHHS Pub. No (PHS) 81–1562, Series 10, No. 134. Washington, DC: US Government Printing Office: 1981.

  20. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL; a standardized measure of biological and psychological functions. JAMA 1963; 185: 94–9.

    Google Scholar 

  21. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–86.

    Article  PubMed  CAS  Google Scholar 

  22. Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1988; 148: 1023–9.

    Article  Google Scholar 

  23. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982–83; 17: 37–49.

    Article  PubMed  Google Scholar 

  24. Sinclair AJ, Bayer AJ, Girling AJ, Woodhouse KW. Older adults diabetes mellitus and visual acuity: a community-based case-control study. Age Ageing 2000; 29: 335–9.

    Article  PubMed  CAS  Google Scholar 

  25. Kocur I, Resnikoff S. Visual impairment and blindness in Europe and their prevention. Br J Ophthalmol 2002; 86: 716–22.

    Article  PubMed  CAS  Google Scholar 

  26. Rodriguez J, Sanchez R, Munoz B, et al. Causes of blindness and visual impairment in a population-based sample of U.S. Hispanics. Ophthalmology 2002; 109: 737–43.

    Article  Google Scholar 

  27. Klein R, Klein BE, Jensen SC, Moss SE, Cruickshanks KJ. The relation of socioeconomic factors to age-related cataract, maculopathy, and impaired vision. The Beaver Dam Eye Study. Ophthalmology 1994; 101: 1969–79.

    CAS  Google Scholar 

  28. Schillinger D, Piette J, Grumbach K, et al. Closing the loop: physician communication with diabetic patients who have low health literacy. Arch Intern Med 2003; 163: 83–90.

    Article  PubMed  Google Scholar 

  29. Yaffe K, Edwards ER, Covinsky KE, Lui LY, Eng C. Depressive symptoms and risk of mortality in frail, community-living elderly persons. Am J Geriatr Psychiatry 2003; 11: 561–7.

    PubMed  Google Scholar 

  30. Cuijpers P, Smit F. Excess mortality in depression: a meta-analysis of community studies. J Affect Disord 2002; 72: 227–36.

    Article  PubMed  Google Scholar 

  31. Rosengren A, Wilhelmsen L. Physical activity protects against coronary death and deaths from all causes in middle-aged men. Evidence from a 20-year follow-up of the primary prevention study in Goteborg. Ann Epidemiol 1997; 7: 69–75.

    CAS  Google Scholar 

  32. Resnikoff S, Pararajasegaram R. Blindness prevention programmes: past, present, and future. Bull World Health Organ 2001; 79: 222–6.

    PubMed  CAS  Google Scholar 

  33. Munoz B, West SK, Rubin GS, et al. Causes of blindness and visual impairment in a population of older Americans: The Salisbury Eye Evaluation Study. Arch Ophthalmol 2000; 118: 819–25.

    Article  PubMed  CAS  Google Scholar 

  34. Mackenzie PJ, Chang TS, Scott IU, et al. Assessment of vision-related function in patients with age-related macular degeneration. Ophthalmology 2002; 109: 720–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Salvatore Maugeri Foundation, Telese/Campoli (Bn), Italy

    Francesco Cacciatore MD, PhD, Claudio Calabrese, Nicola Ferrara, Dino Franco Vitale & Franco Rengo

  2. Chair of Geriatrics, Department of Clinical Medicine, Cardiovascular and Immunological Science, “Federico II” University, Napoli

    Francesco Cacciatore MD, PhD, Pasquale Abete, Guido Luchetti, Luisa Viati, Dario Leosco & Franco Rengo

  3. CNR — Aging Branch — Institute of Neuroscience, Padova

    Stefania Maggi

  4. Chair of Internal Medicine, Department of Animal, Vegetal and Environmental Sciences, University of Molise, Italy

    Nicola Ferrara

Authors
  1. Francesco Cacciatore MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pasquale Abete
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stefania Maggi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guido Luchetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Claudio Calabrese
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Luisa Viati
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Dario Leosco
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nicola Ferrara
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Dino Franco Vitale
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Franco Rengo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesco Cacciatore MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cacciatore, F., Abete, P., Maggi, S. et al. Disability and 6-year mortality in elderly population. Role of visual impairment. Aging Clin Exp Res 16, 382–388 (2004). https://doi.org/10.1007/BF03324568

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03324568

Key Words

Search

Navigation