Visual function and health-related quality of life among people with age-related eye diseases— findings from BRFSS 2005-2007

Background: In the United States, the four most common age-related eye diseases— cataracts, diabetic retinopathy, glaucoma, and age-related macular degeneration—often coexist to exacerbate vision loss among the elderly.

Objectives: Examine the impact of clustering of age-related eye diseases on visual function and health-related quality of life.

Methods: We used data from the 2005 – 2007 Behavioral Risk Factor Surveillance System's (BRFSS) Vision and Access to Eye Care module (n=44965). We estimated the self-reported prevalence of poor visual function, disability, life dissatisfaction, and the average of unhealthy days respectively for people with no eye disease, any one, any two, and three or more of four age-related eye diseases. Multivariate analyses were explored by controlling for socio-demographic and chronic conditions. Predictive marginal and least square means were used to measure the probability and average for each group.

Results: The prevalence of all the outcomes increased with the increased number of the eye disease. After controlling for all covariates, the probability of having poor visual function was 7.2%, 12.7%, 19.8% and 39.2% among people with 0, 1, 2, and 3 or more eye diseases respectively (p<0.001). People with any two eye diseases were more likely to report life dissatisfaction than those with 0 eye disease (7.0% vs.4.6%, p<0.01) and those with 1 eye disease (7.0% vs. 5.5%, p<0.01). The average of physical unhealthy days was 4.5, 5.7, 7.8 and 8.3 for each group (p<0.001).

Conclusion: Clustering of age-related eye diseases was found to be associated with worse visual function and lower quality of life.