Purpose

To compare the incidence and hazard of neuropsychiatric, musculoskeletal, and cardiometabolic conditions among adults with and without vision impairment (VI).

Design

Retrospective cohort study.

Methods

The sample comprised enrollees in a large private health insurance provider in the United States, including 24 657 adults aged ≥18 years with VI and age- and sex-matched controls. The exposure variable, VI, was based on low vision and blindness International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM), diagnosis codes. Physician-diagnosed incident neuropsychiatric, musculoskeletal, and cardiometabolic diseases were identified using ICD codes. Separate Cox proportional hazards regression models were used to assess the association of VI with incidence of 30 chronic conditions, adjusting for Elixhauser Comorbidity Index. Analyses were stratified by age 18-64 years and ≥65 years.

Results

In individuals with VI aged 18-64 years (n=7478), the adjusted hazard of neuropsychiatric (HR 2.1, 95% CI 1.9, 2.4), musculoskeletal (HR 1.8, 95% CI 1.7, 2.0), and cardiometabolic (HR 1.8, 95% CI 1.7, 2.0) diseases was significantly greater than in matched controls (mean 5.5 years follow-up). Similar associations were seen between patients with VI aged ≥65 years (n=17 179) for neuropsychiatric (HR 2.4, 95% CI 2.1, 2.7), musculoskeletal (HR 1.8, 95% CI 1.6, 1.9), and cardiometabolic (HR 1.7, 95% CI 1.4, 2.0) diseases. VI was associated with a higher hazard of each of the 30 conditions we assessed, with similar results in both age cohorts.

Conclusion

Across the life span, adults with VI had an approximately 2-fold greater adjusted hazard for common neuropsychiatric, musculoskeletal, and cardiometabolic disorders compared with matched controls without VI.

中文翻译：

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视力障碍与神经精神、肌肉骨骼和心脏代谢慢性疾病发病率之间的纵向关联

目的

比较有和没有视力障碍的成年人神经精神、肌肉骨骼和心脏代谢疾病的发生率和危害 (VI)。

设计

回顾性队列研究。

方法

该样本由美国一家大型私人医疗保险提供者的登记者组成，包括 24657 名年龄≥18 岁且患有 VI 以及年龄和性别匹配的对照组。暴露变量 VI 基于低视力和失明国际疾病分类，第九版和第十版，临床修改（ICD-9-CM和ICD-10-CM），诊断代码。使用ICD识别医生诊断的神经精神、肌肉骨骼和心脏代谢疾病代码。单独的 Cox 比例风险回归模型用于评估 VI 与 30 种慢性病发病率的关联，并根据 Elixhauser 合并症指数进行调整。分析按年龄 18-64 岁和≥65 岁分层。

结果

在 18-64 岁的 VI 患者 (n=7478) 中，神经精神（HR 2.1，95% CI 1.9，2.4）、肌肉骨骼（HR 1.8，95% CI 1.7，2.0）和心脏代谢（HR 1.8）的调整后风险, 95% CI 1.7, 2.0) 疾病显着高于匹配对照（平均随访 5.5 年）。年龄≥65 岁 (n=17179) 的 VI 患者在神经精神 (HR 2.4, 95% CI 2.1, 2.7)、肌肉骨骼 (HR 1.8, 95% CI 1.6, 1.9) 和心脏代谢 (HR 1.7) 方面也存在类似关联, 95% CI 1.4, 2.0) 疾病。VI 与我们评估的 30 种情况中每一种的较高风险相关，在两个年龄组中的结果相似。

结论

在整个生命周期中，与没有 VI 的匹配对照相比，患有 VI 的成年人患常见神经精神、肌肉骨骼和心脏代谢疾病的调整后风险大约高 2 倍。