Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
National Clinical Research Center for Eye Disease, Shanghai, China.
Epidemiol Health. 2023;45:e2023066. doi: 10.4178/epih.e2023066. Epub 2023 Jul 21.
This population-based, prospective cohort study investigated the association between glaucoma and mortality in older adults.
Participants aged 45 years or older at baseline (47.9% male) were enrolled in 2011 for the China Health and Retirement Longitudinal Study (CHARLS). All-cause mortality was observed during 7 years of follow-up. The baseline data were collected in the 2011 CHARLS, and participants were followed up for 7 years (until 2018). The risk of all-cause mortality was investigated using Cox proportional-hazards regression with age as the time scale, adjusting for significant risk factors and comorbid conditions.
Among the 14,803 participants included, the risk of all-cause death was significantly higher among people with glaucoma than among those without glaucoma, after adjustment for other confounders (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.04 to 2.03). In a subgroup analysis based on the mean age of death, among those who were 75 years and older (n=1,231), the risk of all-cause death was significantly higher in patients with glaucoma than in those without glaucoma (HR, 1.89; 95% CI, 1.24 to 1.89).
Participants with glaucoma had a higher risk of all-cause mortality, especially those aged 75 years and above. Our findings revealed potential mechanisms underlying an association between glaucoma and all-cause mortality. They also highlighted the importance of glaucoma management to prevent premature death in middle-aged and older adults.
本基于人群的前瞻性队列研究旨在探讨老年人青光眼与死亡率之间的关系。
2011 年,参与者年龄在 45 岁及以上(男性占 47.9%),被纳入中国健康与退休纵向研究(CHARLS)。在 7 年的随访期间观察全因死亡率。基线数据于 2011 年 CHARLS 中收集,参与者随访 7 年(截至 2018 年)。使用 Cox 比例风险回归模型,以年龄为时间尺度,调整重要的风险因素和合并症,调查全因死亡率的风险。
在纳入的 14803 名参与者中,调整其他混杂因素后,青光眼患者的全因死亡风险明显高于无青光眼患者(风险比[HR],1.46;95%置信区间[CI],1.04 至 2.03)。根据死亡时的平均年龄进行亚组分析,在 75 岁及以上的人群(n=1231)中,青光眼患者的全因死亡风险明显高于无青光眼患者(HR,1.89;95% CI,1.24 至 1.89)。
青光眼患者全因死亡率较高,尤其是 75 岁及以上的患者。我们的研究结果揭示了青光眼与全因死亡率之间关联的潜在机制,并强调了对中年和老年人进行青光眼管理以预防过早死亡的重要性。