Purpose

To test the hypothesis that food insecurity is associated with greater prevalence of vision impairment (VI).

Design

Cross-sectional, nationally representative survey of US adults.

Methods

Adults 50 years and older were included. Food security category (ie, full, marginal, low, or very low) was assessed by the US Household Food Security Survey Module. Objective presenting VI (PVI) and self-reported VI (SRVI) were assessed by examination and survey, respectively. Separate logistic regression models were constructed with food insecurity category as a predictor of PVI or SRVI. Models were adjusted for age, gender, race, education, income, cigarette use, alcohol use, body mass index, and physical activity. Age-stratified analyses (age 50 through 64 years vs 65 years and older) were also conducted.

Results

Mean age of participants (n = 10,078) was 63.4 years; 8,518 (89.9%) were fully food secure, 1,033 (7.2%) had PVI, and 2,633 (20.1%) had SRVI. Compared with full food security, adjusting for sociodemographic confounders, those with marginal (adjusted odds ratio [aOR], 1.31; 95% CI, 0.97-1.76), low (aOR, 1.61; 95% CI, 1.17-2.23), and very low (aOR, 2.71; 95% CI, 1.75-4.20) food security had higher odds of PVI. Compared with full food security, those with marginal (aOR, 1.58; 95% CI, 1.23-2.02), low (aOR, 1.46; 95% CI, 1.11-1.92), and very low (aOR, 1.85; 95% CI, 1.41-2.41) food security had higher odds of SRVI. The associations between food insecurity and PVI were greater in magnitude in those 65 years and older compared with those age 50 through 64 years.

Conclusions

In this nationally representative sample of US adults 50 years and older, severe food insecurity was increasingly associated with greater prevalence of VI in a dose–response manner.

中文翻译：

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美国 50 岁及以上成年人的粮食不安全和视力障碍

目的

检验粮食不安全与视力障碍患病率增加有关的假设 (VI)。

设计

美国成年人的横断面全国代表性调查。

方法

包括 50 岁及以上的成年人。美国家庭粮食安全调查模块对粮食安全类别（即完全、边缘、低或非常低）进行了评估。客观呈现VI（PVI）和自我报告VI（SRVI）分别通过检查和调查进行评估。构建了单独的逻辑回归模型，将粮食不安全类别作为 PVI 或 SRVI 的预测因子。模型针对年龄、性别、种族、教育、收入、吸烟、饮酒、体重指数和身体活动进行了调整。还进行了年龄分层分析（50 至 64 岁与 65 岁及以上）。

结果

参与者的平均年龄（n = 10,078）为 63.4 岁；8,518 (89.9%) 人完全粮食安全，1,033 (7.2%) 人有 PVI，2,633 (20.1%) 人有 SRVI。与完全粮食安全相比，调整社会人口学混杂因素后，边缘（调整优势比 [aOR]，1.31；95% CI，0.97-1.76）、低（aOR，1.61；95% CI，1.17-2.23）和非常低（aOR，2.71；95% CI，1.75-4.20）粮食安全发生 PVI 的几率更高。与完全粮食安全相比，边缘（aOR，1.58；95% CI，1.23-2.02）、低（aOR，1.46；95% CI，1.11-1.92）和非常低（aOR，1.85；95% CI， 1.41-2.41) 粮食安全有更高的 SRVI 几率。与 50 至 64 岁的人群相比，65 岁及以上人群的粮食不安全与 PVI 之间的关联程度更大。

结论

在这个具有全国代表性的 50 岁及以上美国成年人样本中，严重的粮食不安全与剂量反应方式中 VI 的更高流行率越来越相关。