Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Medical Informatics Center, Peking University, Beijing, China.
J Glob Health. 2022 Jul 22;12:11006. doi: 10.7189/jogh.12.11006.
BACKGROUND: Vision impairment has become a prominent public health issue worldwide. However, little is known about vision impairment prevalence trends among the oldest-old adults in China. This study aimed to examine 20-year trends in the prevalence of vision impairment among the oldest-old Chinese adults and explore the contributions of sociodemographic variables, health behaviours, and chronic conditions to the trends. METHODS: This retrospective longitudinal study used data from the Chinese Longitudinal Healthy Longevity Survey during 1998-2018. A total of 45 849 participants aged ≥80 years at study entry were included. Vision impairment was assessed by an adapted Landolt-C chart at each wave. We examined unadjusted and adjusted nonlinear trends using generalized estimating equation models incorporating a natural cubic spline. We conducted linear regression models to estimate absolute annual prevalence changes and determine the contributions of sociodemographic variables, health behaviours, and chronic conditions to the trends. RESULTS: The fully adjusted prevalence doubled from 5.5% (95% confidence interval (CI) = 5.1%-6.0%) in 1998 to 10.7% (95% CI = 9.9%-11.5%) in 2011 and slightly increased to 11.1% (95% CI = 10.3%-12.0%) in 2018 among the oldest-old Chinese population. Glaucoma, cataracts, cognitive impairment, hearing impairment, and urban residence were significant contributors to changes in vision impairment prevalence during 1998-2018. Differences in vision impairment prevalence associated with glaucoma and cataracts narrowed since 2005. Disparities in the trends among cognitively impaired and unimpaired older adults remained unchanged over time. Similar results were observed in older people with and without hearing impairment. CONCLUSIONS: Vision impairment prevalence among the oldest-old Chinese population increased from 1998 to 2011 and remained stable from 2011 to 2018. Future work is needed to improve the prevention and management of chronic diseases associated with vision impairment to reduce its prevalence.
背景：视力障碍已成为全球一个突出的公共卫生问题。然而，对于中国高龄老年人视力障碍的流行趋势知之甚少。本研究旨在探讨中国高龄老年人视力障碍的 20 年流行趋势，并探讨社会人口学变量、健康行为和慢性疾病对这些趋势的影响。
方法：本回顾性纵向研究使用了 1998 年至 2018 年期间中国健康长寿纵向研究的数据。共纳入 45849 名在研究开始时年龄≥80 岁的参与者。视力障碍采用改良的 Landolt-C 图表在每一波次进行评估。我们使用广义估计方程模型，结合自然三次样条，分别对未调整和调整后的非线性趋势进行了检验。我们还进行了线性回归模型，以估计绝对年流行率变化，并确定社会人口学变量、健康行为和慢性疾病对这些趋势的影响。
结果：在 1998 年至 2011 年期间，经过充分调整后的视力障碍患病率从 5.5%（95%置信区间（CI）=5.1%-6.0%）翻了一番，达到 10.7%（95% CI=9.9%-11.5%），2018 年略有上升，达到 11.1%（95% CI=10.3%-12.0%）。青光眼、白内障、认知障碍、听力障碍和城市居住是导致 1998 年至 2018 年期间视力障碍患病率变化的重要因素。自 2005 年以来，青光眼和白内障相关的视力障碍患病率差异有所缩小。认知障碍者和无认知障碍者之间的趋势差异随着时间的推移没有变化。在有听力障碍和无听力障碍的老年人中，也观察到了类似的结果。
结论：中国高龄老年人的视力障碍患病率从 1998 年到 2011 年有所增加，从 2011 年到 2018 年保持稳定。需要进一步努力改善与视力障碍相关的慢性疾病的预防和管理，以降低其患病率。
Geriatr Gerontol Int. 2019-4-8
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