Department of Family Medicine, McGill University Faculty of Medicine, Montreal, Québec, Canada.
Centre for Public Health, Queen's University Belfast, Belfast, UK.
Br J Ophthalmol. 2023 Nov;107(11):1597-1605. doi: 10.1136/bjo-2022-321577. Epub 2022 Aug 19.
To compare the effects of pre-existing and new self-reported vision impairment (VI), and its correction, on all-cause mortality among Chinese adults aged 45 years and older.
We used four waves of data from the China Health and Retirement Longitudinal Study. Our analytical cohort consists of 15 808 participants aged 45 years and older with an average follow-up of 6.4 years. Exposures included pre-existing self-reported VI and vision correction (time-independent exposures), new self-reported VI and vision correction (time-dependent exposures). Outcomes were measured as the risk of all-cause mortality and the risk stratification for pre-specified factors.
Compared with participants with normal vision, all-cause mortality was higher among those with pre-existing self-reported VI (crude HR (cHR)=1.29, 95% CI: 1.17 to 1.44; adjusted HR (aHR)=1.22, 95% CI: 1.09 to 1.37) and new self-reported VI (cHR=1.42, 95% CI: 1.28 to 1.58; aHR=1.36, 95% CI: 1.21 to 1.51). Mortality risk was lower among those with high school or higher education. Participants who were wearing eyeglasses/contact lenses or had cataract surgery at baseline did not have significantly higher all-cause mortality (eyeglasses: aHR=0.82, 95% CI: 0.65 to 1.02; cataract surgery: aHR=1.12, 95% CI: 0.74 to 1.69) compared with participants with normal vision. The same was true among participants with new correction of self-reported VI (glasses: aHR=1.01, 95% CI: 0.78 to 1.24; cataract surgery: aHR=0.95, 95% CI: 0.68 to 1.31).
Both pre-existing and new self-reported VI increase all-cause mortality among Chinese adults aged 45 years and older, though visual correction reduces this risk.
比较中国 45 岁及以上成年人中既往和新报告的视力障碍（VI）及其矫正对全因死亡率的影响。
我们使用了中国健康与退休纵向研究的四波数据。我们的分析队列包括 15808 名年龄在 45 岁及以上、平均随访 6.4 年的参与者。暴露因素包括既往自我报告的 VI 和视力矫正（时间独立暴露），新的自我报告的 VI 和视力矫正（时间依赖暴露）。结果以全因死亡率和预先指定因素的风险分层来衡量。
与视力正常的参与者相比，既往自我报告 VI（粗 HR（cHR）=1.29，95%可信区间：1.17 至 1.44；调整 HR（aHR）=1.22，95%可信区间：1.09 至 1.37）和新自我报告 VI（cHR=1.42，95%可信区间：1.28 至 1.58；aHR=1.36，95%可信区间：1.21 至 1.51）的全因死亡率更高。具有高中或以上学历的参与者死亡率风险较低。基线时戴眼镜/隐形眼镜或接受白内障手术的参与者全因死亡率没有显著升高（眼镜：aHR=0.82，95%可信区间：0.65 至 1.02；白内障手术：aHR=1.12，95%可信区间：0.74 至 1.69），与视力正常的参与者相比。同样的情况也适用于新报告的 VI 自我矫正的参与者（眼镜：aHR=1.01，95%可信区间：0.78 至 1.24；白内障手术：aHR=0.95，95%可信区间：0.68 至 1.31）。
既往和新报告的 VI 均会增加中国 45 岁及以上成年人的全因死亡率，尽管视力矫正可以降低这种风险。
