Factors associated with poor health-related quality of life among people with eye diseases: Findings from the 2008 Behavioral Risk Factor Surveillance System

Objective: 1) To compare the health related quality of life (HRQOL) between people with and without age-related eye diseases (i.e., cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy) (ARED); 2) To explore factors associated with poor HRQOL among people with ARED.

Methods: Data were form the 2008 BRFSS eye care and diabetes modules (n=45,873). This study categorized respondents' self reported HRQOL---physical unhealthy days, mental unhealthy days, and activity limitation days--- into zero days and >=1 days, respectively, and the four levels of self-rated health into fair/poor and excellent/good. Multiple logistic regression models were used to explore factors associated with poor HRQOL among people 40+ with ARED. Covariates included demographics, comorbidities, health and eye insurance, and access to eye care. Data analyses were conducted using SAS 9.1. Results: Compared with those without ARED, people with ARED had more physical unhealthy days (7.02 vs. 4.18 days), mental unhealthy days (3.97 vs. 3.35 days), and activity limitation days (7.65 vs. 5.18 days); and a larger proportion of them rated their health as poor/fair (36.59% vs. 18.60%) (all ps<0.001). Among people with ARED, those who cited cost as the reason for not-having eye care were more likely to reporting more physical unhealthy days (AOR=2.04), mental unhealthy days (AOR=1.90), and worse general health (AOR=1.71) (all ps<0.05).

Conclusion: People with eye diseases have much worse HRQOL than those without ARED. To reduce disparities in quality of life, it is important to improve access to eye care for people with eye diseases.