Cugati Sudha, Cumming Robert G, Smith Wayne, Burlutsky George, Mitchell Paul, Wang Jie Jin
Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia.
Arch Ophthalmol. 2007 Jul;125(7):917-24. doi: 10.1001/archopht.125.7.917.
To assess the association of visual impairment, age-related macular degeneration (ARMD), and cataract with long-term mortality.
At baseline, 3654 persons 49 years and older were examined in the Blue Mountains Eye Study (1992-1994). Standardized photographic grading was used to assess ARMD and cataract. Mortality and causes of death occurring between baseline and December 31, 2003, were obtained via data linkage with the Australian National Death Index. Age-standardized mortality rates were calculated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed using Cox models. Result Age-standardized mortality was higher in persons with vs without visual impairment (54.0% vs 34.0%), ARMD (45.8% vs 33.7%), and cataract (39.2% vs 29.5%). After adjusting for factors that predict mortality, neither visual impairment (HR, 1.3; 95% CI, 0.98-1.7) nor ARMD (HR, 1.0; 95% CI, 0.8-1.3) was significantly associated with all-cause mortality in all ages. Among persons younger than 75 years, however, ARMD predicted higher all-cause mortality (HR, 1.6; 95% CI, 1.0-2.4). Any cataract (HR, 1.3; 95% CI, 1.0-1.5) and cortical (HR, 1.2; 95% CI, 0.97-1.4), nuclear (HR, 1.2; 95% CI, 0.98-1.5), and posterior subcapsular (HR, 1.3; 95% CI, 1.0-1.7) cataract were also associated with higher all-cause mortality.
Cataract predicted increased mortality in persons 49 years and older, and ARMD predicted mortality in persons aged 49 to 74 years.
评估视力损害、年龄相关性黄斑变性（ARMD）和白内障与长期死亡率之间的关联。
在基线期，对蓝山眼研究（1992 - 1994年）中3654名49岁及以上的人进行了检查。采用标准化摄影分级来评估ARMD和白内障。通过与澳大利亚国家死亡指数的数据链接，获取基线期至2003年12月31日期间的死亡率和死亡原因。计算年龄标准化死亡率。使用Cox模型评估风险比（HRs）和95%置信区间（CIs）。结果有视力损害者与无视力损害者相比，年龄标准化死亡率更高（54.0%对34.0%），ARMD患者（45.8%对33.7%）以及白内障患者（39.2%对29.5%）。在对预测死亡率的因素进行调整后，视力损害（HR，1.3；95% CI，0.98 - 1.7）和ARMD（HR，1.0；95% CI，0.8 - 1.3）在所有年龄段与全因死亡率均无显著关联。然而，在75岁以下人群中，ARMD预示着更高的全因死亡率（HR，1.6；95% CI，1.0 - 2.4）。任何类型的白内障（HR，1.3；95% CI，1.0 - 1.5）以及皮质性（HR，1.2；95% CI，0.97 - 1.4）、核性（HR，1.2；95% CI，0.98 - 1.5）和后囊下（HR，1.3；95% CI，1.0 - 1.7）白内障也与更高的全因死亡率相关。
白内障预示着49岁及以上人群死亡率增加，ARMD预示着49至74岁人群死亡率增加。
