Court Helen, McLean Gary, Guthrie Bruce, Mercer Stewart W, Smith Daniel J
BMC Med. 2014 Oct 17;12:181. doi: 10.1186/s12916-014-0181-7.
Visual impairment is common in older people and the presence of additional health conditions can compromise health and rehabilitation outcomes. A small number of studies have suggested that comorbities are common in visual impairment; however, those studies have relied on self-report and have assessed a relatively limited number of comorbid conditions.
We conducted a cross-sectional analysis of a dataset of 291,169 registered patients (65-years-old and over) within 314 primary care practices in Scotland, UK. Visual impairment was identified using Read Code ever recorded for blindness and/or low vision (within electronic medical records). Prevalence, odds ratios (from prevalence rates standardised by stratifying individuals by age groups (65 to 69 years; 70 to 74; 75 to 79; 80 to 84; and 85 and over), gender and deprivation quintiles) and 95% confidence intervals (95% CI) of 37 individual chronic physical/mental health conditions and total number of conditions were calculated and compared for those with visual impairment to those without.
Twenty seven of the 29 physical health conditions and all eight mental health conditions were significantly more likely to be recorded for individuals with visual impairment compared to individuals without visual impairment, after standardising for age, gender and social deprivation. Individuals with visual impairment were also significantly more likely to have more comorbidities (for example, five or more conditions (odds ratio (OR) 2.05 95% CI 1.94 to 2.18)).
Patients aged 65 years and older with visual impairment have a broad range of physical and mental health comorbidities compared to those of the same age without visual impairment, and are more likely to have multiple comorbidities. This has important implications for clinical practice and for the future design of integrated services to meet the complex needs of patients with visual impairment, for example, embedding depression and hearing screening within eye care services.
视力障碍在老年人中很常见,其他健康状况的存在会影响健康和康复效果。少数研究表明,合并症在视力障碍患者中很常见;然而,这些研究依赖于自我报告,且评估的合并症数量相对有限。
我们对英国苏格兰314家初级医疗诊所中291,169名注册患者(65岁及以上)的数据集进行了横断面分析。使用电子病历中记录的失明和/或视力低下的读取代码来确定视力障碍。计算并比较了视力障碍患者与非视力障碍患者37种个体慢性身体/心理健康状况的患病率、比值比(根据年龄组(65至69岁;70至74岁;75至79岁;80至84岁;85岁及以上)、性别和贫困五分位数分层标准化患病率得出)和95%置信区间(95%CI)以及合并症总数。
在对年龄、性别和社会剥夺进行标准化后,与无视力障碍的个体相比,29种身体健康状况中的27种以及所有8种心理健康状况在视力障碍个体中被记录的可能性显著更高。视力障碍个体也更有可能患有更多的合并症(例如,五种或更多种疾病(比值比(OR)2.05,95%CI 1.94至2.18))。
与同年龄无视力障碍的患者相比,65岁及以上有视力障碍的患者存在广泛的身体和心理健康合并症,并且更有可能患有多种合并症。这对临床实践以及未来综合服务的设计具有重要意义,以满足视力障碍患者的复杂需求,例如在眼科护理服务中纳入抑郁症和听力筛查。