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

• Published in: British journal of ophthalmology Vol. 86; no. 7; pp. 795 - 800
• Main Authors: Evans, J R, Fletcher, A E, Wormald, R P L, Ng, E Siu-Woon, Stirling, S, Smeeth, L, Breeze, E, Bulpitt, C J, Nunes, M, Jones, D, Tulloch, A
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.07.2002; BMJ; BMJ Publishing Group LTD; Copyright 2002 British Journal of Ophthalmology
• Subjects: Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Blindness; Case studies; Cataracts; Clinical Science; Cohort Studies; elderly; Geriatric Assessment; Health aspects; Humans; Medical sciences; Mortality; Nurses; Nursing care; Nursing homes; Odds Ratio; Older people; Prevalence; Public health; Regression Analysis; Risk; Sex Factors; Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; United Kingdom - epidemiology; Vision disorders; Vision Disorders - epidemiology; Visual impairment; Womens health; United Kingdom; Great Britain; Europe; United Kingdom > UK; Human; Eye disease; Prevalence; Vision disorder; Deficiency; Visual acuity; Epidemiology; Elderly; Public health
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.86.7.795

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%.