Prevalence of visual impairment in people aged 75 years and older in Britain: results from the MRC trial of assessment and management of older people in the community

Aims: To measure the prevalence of visual impairment in a large representative sample of people aged 75 years and over participating in the MRC trial of assessment and management of older people in the community. Methods: 53 practices in the MRC general practice research framework. Data were obtained from 14 600 participants aged 75 years and older. Prevalence of visual impairment overall (binocular visual acuity <6/18) which was categorised separately into low vision (binocular visual acuity <6/18–3/60) or blindness (binocular visual acuity of <3/60). The prevalence of binocular acuity <6/12 was presented for comparison with other studies. Visual acuity was measured using Glasgow acuity charts; glasses, if worn, were not removed. Results: Visual acuity was available for 14 600 people out of 21 241 invited (69%). Among people with visual acuity data, 12.4% overall (1803) were visually impaired (95% confidence intervals 10.8% to 13.9%); 1501 (10.3%) were categorised as having low vision (8.7% to 11.8%), and 302 (2.1%) were blind (1.8% to 2.4%). At ages 75–79, 6.2% of the cohort were visually impaired (5.1% to 7.3%) with 36.9% at age 90+ (32.5% to 41.3%). At ages 75–79, 0.6% (0.4% to 0.8%) of the study population were blind, with 6.9% (4.8% to 9.0%) at age 90+. In multivariate regression, controlling for age, women had significant excess risk of visual impairment (odds ratio 1.43, 95% confidence interval 1.29 to 1.58). Overall, 19.9% of study participants had a binocular acuity of less than 6/12 (17.8% to 22.0%). Conclusion: The results from this large study show that visual impairment is common in the older population and that this risk increases rapidly with advancing age, especially for women. A relatively conservative measure of visual impairment was used. If visual impairment had been defined as visual acuity of <6/12 (American definition of visual impairment), the age specific prevalence estimates would have increased by 60%.

[1]  R. Klein,et al.  The Beaver Dam Eye Study: visual acuity. , 1991, Ophthalmology.

[2]  D. Snydacker,et al.  Blindness and visual impairment in an American urban population. , 1990, Archives of ophthalmology.

[3]  J M Gibson,et al.  Blindness and partial sight in an elderly population. , 1986, The British journal of ophthalmology.

[4]  S. Lewallen,et al.  Gender and blindness: a meta-analysis of population-based prevalence surveys , 2001, Ophthalmic epidemiology.

[5]  Joanne Katz,et al.  Blindness and Visual Impairment in an American Urban Population-Reply , 1990 .

[6]  P. Mitchell,et al.  Visual acuity and the causes of visual loss in Australia. The Blue Mountains Eye Study. , 1996, Ophthalmology.

[7]  J Katz,et al.  Blindness and visual impairment in an American urban population. The Baltimore Eye Survey. , 1990, Archives of ophthalmology.

[8]  Jie-Jin Wang,et al.  Visual impairment in nursing home residents: the Blue Mountains Eye Study , 1997, The Medical journal of Australia.

[9]  A. Reidy,et al.  Prevalence of serious eye disease and visual impairment in a north London population: population based, cross sectional study , 1998, BMJ.

[10]  Robert Chambers,et al.  Introduction to Part A , 2003 .

[11]  Chris J. Skinner,et al.  Analysis of complex surveys , 1991 .

[12]  H. Taylor,et al.  Visual impairment in Australia: distance visual acuity, near vision, and visual field findings of the Melbourne Visual Impairment Project. , 1997, American journal of ophthalmology.

[13]  K Bandeen-Roche,et al.  Function and visual impairment in a population-based study of older adults. The SEE project. Salisbury Eye Evaluation. , 1997, Investigative ophthalmology & visual science.

[14]  A. Sommer,et al.  The prevalence of blindness and visual impairment among nursing home residents in Baltimore. , 1995, The New England journal of medicine.

[15]  P. McGraw,et al.  Visual acuity measurements in a national sample of British elderly people , 2000, The British journal of ophthalmology.

[16]  P. McGraw,et al.  Glasgow Acuity Cards: a new test for the measurement of letter acuity in children , 1993, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[17]  A. Haines,et al.  Visual problems in the elderly population and implications for services. , 1992, BMJ.

[18]  A Hofman,et al.  Age-specific prevalence and causes of blindness and visual impairment in an older population: the Rotterdam Study. , 1998, Archives of ophthalmology.