New paper offers first look at national eye health data in more than a decade

January 12, 2023

Contact: Jon Meerdink ([email protected])

ANN ARBOR — A new paper is exploring data from the first national study to directly assess vision impairment and blindness in older American adults in more than a decade. The study, run jointly by members of the University of Michigan’s Institute for Social Research, the University of Michigan Medical School, Johns Hopkins University, and the National Opinion Research Center (NORC) at the University of Chicago has revealed new insights about vision health in America’s aging population.

According to Dr. Joshua Ehrlich, a population health researcher at ISR’s Survey Research Center and a senior author on the paper, the study was conducted using data from the National Health and Aging Trends Study (NHATS). This study collects nationally representative information on Medicare beneficiaries aged 65 and older, a feature Ehrlich and the rest of the research team used to their advantage.

“As a Co-Investigator of the NHATS study, I helped to develop a set of vision measures to embed within the NHATS study,” he said. “And by virtue of the way NHATS is designed, we were able to draw conclusions that are generalizable nationally.”

The paper finds that the prevalence of vision impairment and blindness increases sharply with age. Thus, as the population continues to age,  an increasing number of people are at risk for these conditions simply because the demographics of the United States are changing. 

In addition to measuring visual acuity, this study also included assessments of vision that are not commonly employed in population-based studies, namely contrast sensitivity–how well people are able to see things on similarly colored surfaces or backgrounds. Since this measure of visual function is strongly associated with day-to-day functioning, national data on contrast sensitivity impairment provide important new insights into the vision health of older U.S. adults.

“This is quite unique and important because we know contrast sensitivity can be affected early in the course of eye disease, even before visual acuity in some cases,” said Ehrlich. “For some, it may also be more strongly tied to daily function and disability than visual acuity. So having this measure in NHATS in addition to visual acuity is a major contribution.”

The findings in the paper could be useful from a public policy perspective. As the population continues to age, more people could be affected by vision issues, and future research along these lines could help inform how to best target resources.

“For example, here at Michigan, some of my colleagues run community outreach programs in Flint and Detroit that aim to target those who are at highest risk for vision impairment,” Ehrlich said. “As we develop these kinds of programs, population-based data can be used for surveillance to provide insights into whether or not we’re chipping away at disparities. It gives us the data needed to measure impact at the population level.”

Future rounds of NHATS will provide even more data on the vision health of older U.S. adults. Through annual measurement and planned oversampling of high risk groups, we will gain even richer insights into vision health and the factors that influence and are influenced by healthy vision.

“In fact, beginning next year, we will be able to estimate the number of new cases of vision impairment and blindness in the older U.S. population – this is something that has bever previously been possible at a national level.”

The full paper is available in JAMA Ophthalmology on January 12, 2023.

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