Objective
To describe the relationships of lifestyle characteristics to changes in vision and
incidence of visual impairment (VI) over a 20-year period in the Beaver Dam Eye Study
(BDES).
Design
Longitudinal, population-based cohort study.
Participants
A cohort of 4926 persons aged 43 to 86 years participated in the baseline examinations
in 1988–1990, and 3721, 2962, 2375, and 1913 persons participated in follow-up examinations
in 1993–1995, 1998–2000, 2003–2005, and 2008–2010, respectively.
Methods
Best-corrected visual acuity (BCVA) measured by a modified Early Treatment Diabetic
Retinopathy Study protocol.
Main Outcome Measures
Change in number of letters read correctly and incidence of VI based on BCVA in the
better eye assessed at each examination over a 20-year period.
Results
The 20-year cumulative incidence of VI was 5.4%. There was a mean loss of 1.6 letters
between examinations, with a 20-year loss of 6.6 letters. While adjusting for age,
income, and age-related macular degeneration (AMD) severity, being a current or past
smoker was related to a greater change in the numbers of letters lost. Persons who
had not consumed alcoholic beverages over the past year and sedentary persons had
higher odds of incident VI than persons who drank occasionally or who were physically
active. For example, in women with early AMD and annual household income less than
$10 000, the estimated 20-year cumulative incidence of VI in those who drank occasionally
and were physically active was 5.9% compared with 25.8% in women who had not consumed
alcoholic beverages over the past year and were sedentary.
Conclusions
Three modifiable behaviors—smoking, drinking alcohol, and physical activity—were associated
with changes in vision. Further evidence that changes in these behaviors will result
in less loss of vision is needed because of the expected increase in the burden of
VI due to the aging of the population.
Abbreviations and Acronyms:
AMD ( age-related macular degeneration), BCVA ( best corrected visual acuity), BDES ( Beaver Dam Eye Study), CI ( confidence interval), OR ( odds ratio), VA ( visual acuity), VI ( visual impairment)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: March 03, 2014
Accepted:
January 2,
2014
Received in revised form:
December 30,
2013
Received:
September 26,
2013
Footnotes
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Funding: The National Institutes of Health Grant EY06594 (R.K. and B.E.K.K.) provided funding for the entire study, including collection and analyses of data; further support for data analyses was provided by Research to Prevent Blindness (R.K. and B.E.K.K., Senior Scientific Investigator Awards), New York, New York. R.K. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The funding organizations had no role in the design or conduct of this research.
Identification
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© 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
