Over one-quarter of US adults over 71 years have visual impairment

Jan 18, 2023

Article

The main outcomes were the national prevalence of impaired presenting distance VA, presenting near VA, and contrast sensitivity.

In excess of 25% of adults in the US who are 71 years and older have visual impairment. The differences in visual function were based on socioeconomic and demographic factors,¹ according to first author Olivia Killeen, MD, MS, from the Department of Ophthalmology and Visual Sciences, and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.

She and her colleagues conducted a survey-based study to determine the current updated national prevalence estimates of vision impairment and blindness among older US adults based on objective visual function testing.

The study was a secondary data analysis of the 2021 National Health and Aging Trends Study (NHATS), a population-based, nationally representative panel study of Medicare beneficiaries 65 years and older, the authors explains.

The participants were community-dwelling older adults or proxies who completed in-person interviews; annual follow-up interviews are conducted regardless of residential status. Round 11 NHATS data were collected from June to November 2021, and data were analyzed in August 2022.

The interventions were tablet-based tests of the distance and near visual acuity (VA) and contrast sensitivity with the participants’ habitual correction.

The study included 3,817 respondents. Ultimately, 3,026 respondents were included who had both completed the sample person interview and had no data missing; 29.5% of these respondents were aged 71 to 74 years old and 55% were women.

The main outcomes were the national prevalence of impaired presenting distance VA (>0.30 logMAR, Snellen equivalent worse than 20/40), presenting near VA (>0.30 logMAR, Snellen equivalent worse than 20/40), and contrast sensitivity (>1 standard deviation below the sample mean).

Visual impairment findings

“The prevalence of visual impairment in US adults 71 years and older was 27.8% (95% confidence interval [CI], 25.5%-30.1%). Distance and near VA and contrast sensitivity impairments were prevalent in 10.3% (95% CI, 8.9%-11.7%), 22.3% (95% CI, 20.3%-24.3%), and 10.0% (95% CI, 8.5%-11.4%), respectively,” the investigators reported.

Factors that were associated with all type of visual impairment included older age, lower education level, and lower income were associated with all types of visual impairment. Higher prevalence rates of near VA and contrast sensitivity impairments were associated with non-White race and Hispanic ethnicity.

The study concluded, “More than 1 in 4 US adults aged 71 years and older were visually impaired in 2021, which was higher than prior estimates. Differences in the prevalence of visual impairment by socioeconomic and demographic factors were observed. These data could inform public health planning.”