Nagarajan Niranjani, Leziak Karolina, Zhou Yunshu, Mumby Rachel, Hu Mengyao, Ferrante Lauren E, De Lott Lindsey B, Rein David B, Ehrlich Joshua R
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.
University of Michigan Medical School, Ann Arbor, Michigan, USA.
J Am Geriatr Soc. 2025 Mar;73(3):782-790. doi: 10.1111/jgs.19308. Epub 2024 Dec 9.
Visual impairment (VI) is common in older adults and is associated with adverse health outcomes. However, the association between objectively assessed VI and recurrent hospitalization remains unclear.
To investigate the association of different domains of visual function with recurrent hospitalization in older adults in the United States.
We used data from Round 11 of the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries, which included objective measures of distance and near visual acuity and contrast sensitivity. Using multivariable logistic regression models, we analyzed the association between VI (distance and near acuity <20/40, contrast sensitivity <1 SD below the sample mean) and prior year hospitalization and estimated marginal predicted probabilities of any (≥1) and recurrent (>1) hospitalization. Models were adjusted for demographic factors and comorbid medical conditions and accounted for NHATS complex survey design.
The sample included 2960 respondents aged 71 and older (median age 81 years; 45% male, 82% non-Hispanic White). The predicted probability of hospitalization for those with any type of VI was 19.2% (15.9-22.6) versus 16.7% (14.9-18.6) for those without VI. The predicted probability of recurrent hospitalization for those with any type of VI was 7.2% (4.8-9.7) versus 4.1% (3.1-5.2) for those without VI. Near VI was significantly associated with recurrent hospitalization (OR = 2.04 [1.6, 3.61], p = 0.02), independent of other visual function measures, while other types of VI were not.
Near VI is significantly associated with recurrent hospitalization in older US adults. Future studies should determine whether improving near vision affects the likelihood of recurrent hospitalization.
视力损害（VI）在老年人中很常见，且与不良健康后果相关。然而，客观评估的VI与再次住院之间的关联仍不明确。
研究美国老年人视觉功能不同领域与再次住院之间的关联。
我们使用了国家健康与老龄化趋势研究（NHATS）第11轮的数据，这是一项对医疗保险受益人的全国代表性调查，其中包括远距离和近距离视力以及对比敏感度的客观测量。我们使用多变量逻辑回归模型，分析了VI（远距离和近距离视力<20/40，对比敏感度低于样本均值1个标准差）与上一年住院之间的关联，并估计了任何（≥1次）和再次（>1次）住院的边际预测概率。模型针对人口统计学因素和合并症进行了调整，并考虑了NHATS复杂的调查设计。
样本包括2960名71岁及以上的受访者（中位年龄81岁；45%为男性，82%为非西班牙裔白人）。任何类型VI患者的住院预测概率为19.2%（15.9 - 22.6），而无VI患者为16.7%（14.9 - 18.6）。任何类型VI患者的再次住院预测概率为7.2%（4.8 - 9.7），而无VI患者为4.1%（3.1 - 5.2）。近距离VI与再次住院显著相关（OR = 2.04 [1.6, 3.61]，p = 0.02），独立于其他视觉功能测量指标，而其他类型的VI则不然。
近距离VI与美国老年成年人再次住院显著相关。未来的研究应确定改善近距离视力是否会影响再次住院的可能性。
