From the University of Michigan Medical School, University of Michigan (A.K.), Ann Arbor, Michigan; Harvard T.H. Chan School of Public Health, Harvard University (A.K.), Boston, Massachusetts.
Institute for Healthcare Policy and Innovation, University of Michigan (K.S., N.K., L.B.D.L., M.D.P., M.A.M., J.R.E.), Ann Arbor, Michigan.
Am J Ophthalmol. 2022 Mar;235:163-171. doi: 10.1016/j.ajo.2021.09.004. Epub 2021 Sep 20.
To compare the incidence and hazard of neuropsychiatric, musculoskeletal, and cardiometabolic conditions among adults with and without vision impairment (VI).
Retrospective cohort study.
The sample comprised enrollees in a large private health insurance provider in the United States, including 24 657 adults aged ≥18 years with VI and age- and sex-matched controls. The exposure variable, VI, was based on low vision and blindness International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM), diagnosis codes. Physician-diagnosed incident neuropsychiatric, musculoskeletal, and cardiometabolic diseases were identified using ICD codes. Separate Cox proportional hazards regression models were used to assess the association of VI with incidence of 30 chronic conditions, adjusting for Elixhauser Comorbidity Index. Analyses were stratified by age 18-64 years and ≥65 years.
In individuals with VI aged 18-64 years (n=7478), the adjusted hazard of neuropsychiatric (HR 2.1, 95% CI 1.9, 2.4), musculoskeletal (HR 1.8, 95% CI 1.7, 2.0), and cardiometabolic (HR 1.8, 95% CI 1.7, 2.0) diseases was significantly greater than in matched controls (mean 5.5 years follow-up). Similar associations were seen between patients with VI aged ≥65 years (n=17 179) for neuropsychiatric (HR 2.4, 95% CI 2.1, 2.7), musculoskeletal (HR 1.8, 95% CI 1.6, 1.9), and cardiometabolic (HR 1.7, 95% CI 1.4, 2.0) diseases. VI was associated with a higher hazard of each of the 30 conditions we assessed, with similar results in both age cohorts.
Across the life span, adults with VI had an approximately 2-fold greater adjusted hazard for common neuropsychiatric, musculoskeletal, and cardiometabolic disorders compared with matched controls without VI.
比较有和无视力障碍（VI）的成年人中神经精神、肌肉骨骼和心血管代谢疾病的发生率和危险。
回顾性队列研究。
该样本包括美国一家大型私人健康保险提供商的参保者，包括 24657 名年龄≥18 岁的有 VI 和年龄及性别匹配对照者。暴露变量 VI 基于国际疾病分类第 9 和第 10 修订版临床修正版（ICD-9-CM 和 ICD-10-CM）的低视力和失明诊断代码。使用 ICD 代码确定医生诊断的新发神经精神、肌肉骨骼和心血管代谢疾病。使用单独的 Cox 比例风险回归模型评估 VI 与 30 种慢性疾病发生率的关联，调整了 Elixhauser 合并症指数。分析按 18-64 岁和≥65 岁年龄分层。
在 18-64 岁有 VI 的个体（n=7478）中，神经精神疾病（HR 2.1，95%CI 1.9，2.4）、肌肉骨骼疾病（HR 1.8，95%CI 1.7，2.0）和心血管代谢疾病（HR 1.8，95%CI 1.7，2.0）的调整后危险显著高于匹配对照组（平均 5.5 年随访）。在≥65 岁有 VI 的患者（n=17179）中也观察到了类似的关联，包括神经精神疾病（HR 2.4，95%CI 2.1，2.7）、肌肉骨骼疾病（HR 1.8，95%CI 1.6，1.9）和心血管代谢疾病（HR 1.7，95%CI 1.4，2.0）。VI 与我们评估的 30 种疾病中的每一种都有更高的发病危险，在两个年龄组中均有类似的结果。
在整个生命周期中，与无 VI 的匹配对照者相比，有 VI 的成年人常见的神经精神、肌肉骨骼和心血管代谢疾病的调整后危险大约高 2 倍。
