Is there a direct association between age-related eye diseases and mortality? The Rotterdam Study☆
Presented at annual meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, May 2001.
Received 25 March 2002; accepted 4 December 2002.
Abstract
Purpose
To study mortality in subjects with age-related maculopathy (ARM), cataract, or open-angle glaucoma (OAG) in comparison with those without these disorders.
Design
Population-based prospective cohort study.
Participants
Subjects (n = 6339) aged 55 years and older from the population-based Rotterdam Study for whom complete information on eye disease status was present.
Main outcome measures
Vital status continuously monitored from 1990 until January 1, 2000.
Methods
The diagnosis of ARM was made according to the International Classification System. Cataract, determined on biomicroscopy, was defined as any sign of nuclear or (sub)cortical cataract, or both, in at least one eye with a visual acuity of 20/40 or less. Aphakia and pseudophakia in at least one eye were classified as operated cataract. Definite OAG was defined as a glaucomatous optic neuropathy combined with a glaucomatous visual field defect. Diagnoses were assessed at baseline. Mortality hazard ratios were computed using Cox proportional hazard regression analysis, adjusted for appropriate confounders (age, gender, smoking status, body mass index, cholesterol level, atherosclerosis, hypertension, history of cardiovascular disease, and diabetes mellitus).
Results
The adjusted mortality hazard ratio for subjects with AMD (n = 104) was 0.94 (95% confidence interval [CI], 0.52–1.68), with biomicroscopic cataract (n = 951) was 0.94 (95% CI, 0.74–1.21), with surgical cataract (n = 298) was 1.20 (95% CI, 0.86–1.68), and with definite OAG (n = 44) was 0.39 (95% CI, 0.10–1.55).
Conclusions
Both ARM and cataract are predictors of shorter survival because they have risk factors that also affect mortality. When adjusted for these factors, ARM, cataract, and OAG were themselves not significantly associated with mortality.
1Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
2The Netherlands Ophthalmic Research Institute, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
3Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
4Department of Ophthalmology, Academic Medical Center, Amsterdam, The Netherlands
Correspondence to Paulus T. V. M. de Jong, MD, PhD, The Netherlands Ophthalmic Research Institute, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands.
Supported by grants from Zorg Onderzoek Nederland (grant no.: 22000035), The Hague; Topcon Europe BV, Capelle a/d IJssel; the Netherlands Society for Prevention of Blindness, Doorn Optimix Foundation, Amsterdam; Landelijke Stichting voor Blinden en Slechtzienden, Utrecht; Haagsch Oogheelkundig Fonds, The Hague; Stichting Blindenpenning, Amsterdam; Rotterdamse Vereniging voor Blindenbelangen, Rotterdam; Stichting Blindenhulp, The Hague; Stichting ROOS, Rotterdam, The Netherlands.
The authors have no proprietary interests in the materials mentioned in this study.
ABSTRACT