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Mixed Lens Opacities and Subsequent Mortality
Sheila K. West, PhD;
Beatriz Muñoz, MS;
Jennifer Istre, MPH;
Gary S. Rubin, PhD;
Susan M. Friedman, MD;
Linda P. Fried, MD;
Karen Bandeen-Roche, PhD;
Oliver D. Schein, MD
Arch Ophthalmol. 2000;118:393-397.
Background Previous studies have found an association between cataract or lens opacity and increased risk of mortality. Further work on determining explanatory factors for this association is needed.
Objectives To determine, in a population-based cohort of older persons, the 2-year risk of death associated with different types of lens opacities; whether an association of mortality and lens opacity is explained by confounding risk factors such as smoking, diabetes, age, race, and sex, which are known to be related to opacity and mortality; whether lens opacity is a marker for health status; and whether there are differences in cause-specific mortality for persons with and without lens opacity.
Main Outcome Measure Two-year mortality rate.
Methods The Salisbury Eye Evaluation Project consists of a random sample of 2520 residents of Salisbury, Md, aged 65 to 84 years. At baseline, lens photographs were taken to document nuclear, cortical, posterior subcapsular cataract, and mixed opacities. Data on education, smoking, alcohol use, hypertension, diabetes and other comorbid conditions, handgrip strength, and body mass index were also collected. Two-year follow-up was conducted for mortality and cause of death.
Results Nuclear opacity, particularly severe nuclear opacity, and mixed opacities with nuclear were significant predictors of mortality independent of body mass index, comorbid conditions, smoking, age, race, and sex (mixed nuclear: odds ratio, 2.23; 95% confidence interval, 1.26-3.95).
Conclusion Lens opacity status is an independent predictor of 2-year mortality, an association that could not be explained by potential confounders.
From the Department of Ophthalmology, Dana Center for Preventive Ophthalmology (Drs West, Muñoz, and Schein and Ms Istre), and Lions Vision Research Center (Dr Rubin), Wilmer Eye Institute; the Departments of Medicine and Epidemiology (Dr Fried), and the Department of Biostatistics, School of Hygiene and Public Health (Dr Bandeen-Roche), Johns Hopkins University, Baltimore, Md; and the Department of Geriatrics, Bayview Medical Center, Baltimore (Dr Friedman). Dr West is a Research to Prevent Blindness senior investigator. Dr Bandeen-Roche is a Brookdale National Fellow.
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