Abstract
Objectives
To investigate whether biological markers of health differ among older adults with visual impairment compared to those with normal vision.
Design
We use data from the National Health and Nutrition Examination Survey (1999–2006) to investigate clinically defined at-risk levels for 10 biological markers.
Setting
Survey participants were non-institutionalized.
Participants
Nationally representative (U.S.) sample of older adults age 65 and older, categorized as having blindness (20/200 or worse), low vision (20/40 to 20/100) or normal vision (better than 20/40).
Intervention
Separate binary logistic regressions (one for each biomarker, with two at-risk cut points for BMI: obese and underweight) were computed to determine the odds of having at-risk levels of each biomarker.
Measurements
Biomarkers included: systolic and diastolic blood pressure, highdensity lipoprotein, low-density lipoprotein (LDL) cholesterol, total cholesterol, glycated hemoglobin, body mass index (BMI), fasting triglycerides, C-reactive protein, and plasma homocysteine.
Results
Older adults who were blind were more likely to have high-risk levels of LDL cholesterol, homocysteine, and to be underweight (BMI>18.5). Similarly, older adults with LV were more likely to have high-risk levels of homocysteine compared to older adults with normal vision.
Conclusion
As several of the high-risk biomarkers associated with visual impairment were diet-related, our results suggest the importance of nutrition and diet programs aimed towards educating older people who are visually impaired.
Similar content being viewed by others
References
Crews JE, Campbell VA. Vision impairment and hearing loss among communitydwelling older americans: Implications for health and functioning. American Journal of Public Health 2004;94:823–829.
Haymes SA, Johnston AW, Heyes AD. Relationship between vision impairment and ability to perform activities of daily living. Ophthalmic and Physiological Optics 2002;22:79–91.
West CG, Gildengorin G, Haegerstrom-Portnoy G, Schneck ME, Lott L, Brabyn JA. Is vision function related to physical functional ability in older adults? Journal of the American Geriatric Society 2002;50:136–145.
Chia E, Mitchell P, Rochtchina E, Foran S, Wang J. Unilateral visual impairment and health related quality of life: The Blue Mountains Eye Study. British Journal of Ophthalmology 2003;87:392–395.
Wang J, Mitchell P, Smith W. Vision and low self-rated health: The Blue Mountains Eye Study. Investigative Ophthalmology & Visual Science 2000;41:49–54.
Laforge R, Spector W, Sternberg J. The relationship of vision and hearing impairment to one-year mortality and functional decline. Journal of Aging Health 1992;4:126–148.
McCarty CA, Nanjan MB, Taylor HR. Vision impairment predicts 5 year mortality. British Journal of Ophthalmology 2001;85:322–326.
Wang JJ, Mitchell P, Simpson JM, Cumming RG, Smith W. Visual impairment, agerelated cataract, and mortality. Archives of Ophthalmology 2001;119(8):1186–1190.
Jacobs JM, Hammerman-Rozenberg R, Maaravi Y, Cohen A, Stessman J. The impact of visual impairment on health, function and mortality. Aging Clinical and Experimental Research 2005;17:281–286.
Felson DT, Anderson JJ, Hannan MT, Milton RC, Wilson PW, Kiel DP. Impaired vision and hip fracture: The Framingham Study. Journal of the American Geriatrics Society 1989;37:495–500.
Lord SR, Dayhew J. Visual risk factors for falls in older people. Journal of the American Geriatrics Society 2001;49:508–515.
Harris TB, Ferrucci L, Tracy RP, Corti MC, Wacholder S, EttingerJr WH, Heimovitz H, Cohen HJ, Wallace R. Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. The American Journal of Medicine 1999;106:506–512.
Wilson CJ, Finch CE, Cohen HJ. Cytokines and cognition-the case for A head-to-toe inflammatory paradigm. Journal of the American Geriatrics Society 2002;50:2041–2456.
Cohen HJ, Harris T, Pieper CF. Coagulation and activation of inflammatory pathways in the development of functional decline and mortality in the elderly. The American Journal of Medicine 2003;114:180–187.
Cesari M, Penninx, B. W. J. H., Newman AB, Kritchevsky SB, Nicklas BJ, Sutton-Tyrrell K, Tracy RP, Rubin SM, Harris TB, Pahor M. Inflammatory markers and cardiovascular disease (the health, aging and body composition [health ABC] study). American Journal of Cardiology 2003;92:522–528.
Crimmins EM, Alley D, Reynolds SL, Johnston M, Karlamangla A, Seeman T. Changes in biological markers of health: Older Americans in the 1990s. Journal of Gerontology: Medical Sciences 2005;60A:1409–1413.
Nagi SZ. An epidemiology of disability among adults in the UNITED STATES. The Milbank Memorial Fund Quarterly: Health and Society 1976;54:439–467.
Verbrugge LM, Jette A. The disablement process. Social Science Medicine 1994;39:1–14.
Crimmins EM. Trends in the health of the elderly. Annual Review of Public Health 2004;25:79–98.
Hyman L, Schachat AP, He Q, Leske MC. Hypertension, cardiovascular disease, and age-related macular degeneration. Archives of Ophthalmology 2000;118:351–358.
Dielemans I, Vingerling JR, Algra D, Hofman A, Grobbee DE, de Jong PT. Primary open-angle glaucoma, intraocular pressure, and systemic blood pressure in the general elderly population: The Rotterdam Study. Ophthalmology 1995;102:54–60.
Smith W, Mitchell P, Leeder SR, Wang JJ. Plasma fibrinogen levels, other cardiovascular risk factors, and age-related maculopathy. Archives of Ophthalmology 1998;116:583–587.
Vine AK, Stader J, Branham K, Musch DC, Swaroop A. Biomarkers of cardiovascular disease as risk factors for age-related macular degeneration. Ophthalmology 2005 12;112:2076–2080.
Schalkwijk CG, Poland DCW, van Dijk W, Kok A, Emeis JJ, Dräger AM, Doni A, van Hinsbergh, V. W. M., Stehouwer CDA. Plasma concentration of C-reactive protein is increased in type I diabetic patients without clinical macroangiopathy and correlates with markers of endothelial dysfunction: Evidence for chronic inflammation. Diabetologia 1999;42:351–357.
Adamis AP. Is diabetic retinopathy an inflammatory disease? British Journal of Ophthalmology 2002;86:363–365.
Crews JE, Campbell VA. Health conditions, activity limitations, and participation restrictions among older people with visual impairments. Journal of Visual Impairment & Blindness 2001;95:453–467.
Claesson S, Morrison A, Wertheimer AI, Berger ML. Compliance with prescribed drugs: Challenges for the elderly population. Pharmacy World & Science 1999;21:256–259.
Hasan SJ, Cohen JA. Posterior segment diseases in the older adult. In: A. A. Rosenbloom, editor. Rosenbloom and Morgan’s vision and aging. St. Louis, MO: Butterworth Heinemann Elsevier; 2007. p 105–131.
Adams KF, Schatzkin A, Harris TB, Kipnis V, Maouw T, Ballard-Barbash R, Hollenbeck A, Leitzman MF. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. New England Journal of Medicine 2006; 355:763–778.
Alley DE, Chang VW. The changing relationship of obesity and disability, 1988–2004. Journal of the American Medical Association 2007; 298:2020–2027.
Green SB, Salkind NJ, Akey TM. Using SPSS for windows: Analyzing and understanding data. 2nd ed. Upper Saddle River, New Jersey: Prentice Hall; 2000.
Berger S, Porell F. The association between low vision and function. Journal of Aging and Health 2008;20:504–525.
Horowitz A. The prevalence and consequences of vision impairment in later life. Topics in Geriatric Rehabilitation. Vision Rehabilitation. 2004;20:185–195.
Travis LA, Boerner K, Reinhardt JP, Horowitz A. Exploring functional disability in older adults with low vision. Journal of Visual Impairment and Blindness 2004;98:534–545.
Hassell JB, Lamoureux EL, Keeffe JE. Impact of age related macular degeneration on quality of life. British Journal of Ophthalmology 2006;90:593–596.
Crimmins E, Vasunilashorn S, Kim JK, Alley D. Biomarkers related to aging in human populations. Advances in Clinical Chemistry 2008;46:161–216.
Seeman TE, Crimmins E, Huang MH, Singer B, Bucur A, Gruenewald T, et al. Cumulative biological risk and socio-economic differences in mortality: MacArthur Studies of Successful Aging. Social Science and Medicine 2004;58:1985–1997.
Danesh J, Lewington S. Plasma homocysteine and coronary heart disease: Systematic review of published epidemiological studies. Journal of Cardiovascular Risk 1998;5:229–232.
Selhub J, Jacques PF, Rosenberg IH, Rogers G, Bowman BA, Gunter EW, Wright JD, Johnson CL. Serum total homocysteine concentrations in the third national health and nutrition examination survey (1991–1994): Population reference ranges and contribution of vitamin status to high serum concentrations. Annals of Internal Medicine 1999;131:331–339.
Boushey CJ, Beresford SAA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease: Probable benefits of increasing folic acid intakes. Journal of the American Medical Association 1995;274:1049–1057.
Refsum H, Ueland PM, Nygard O, Vollset SE. Homocysteine and cardiovascular disease. Annual Review of Medicine 1998;49:31–62.
Wilcken DE. Novel risk factors for vascular disease: The homocysteine hypothesis of cardiovascular disease. Journal of Cardiovascular Risk 1998;5:217–221.
Tiemeier H, van Tuijl HR, Hofman A, Meijer J, Kiliaan AJ, Breteler MMB. Vitamin B12, folate, and homocysteine in depression: The Rotterdam Study. American Journal of Psychiatry 2002;159:2099–2101.
Clarke R, Smith AD, Jobst KA, Refsum H, Sutton L, Ueland PM. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease. Archives of Neurology 1998;55:1449–1455.
Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, D’Agostino RB, Wilson PWF, Wolf PA. Plasma homocysteine as a risk factor for dementia and Alzheimer’s disease. New England Journal of Medicine 2002;346:476–483.
Kato I, Dnistrian AM, Schwartz M, Toniolo P, Koenig K, Shore RE, Akhmedkhanov A, Zeleniuch-Jacquotte A, Riboli E. Serum folate, homocysteine and colorectal cancer risk in women: A nested case-control study. British Journal of Cancer 1999;79:1917–1921.
Bates CJ, Mansoor MA, van der Pols J, Prentice A, Cole TJ, Finch S. Plasma total homocysteine in a representative sample of 972 British men and women aged 65 and over. British Journal of Clinical Nutrition 1997;51:691–697.
Nygard O, Refsum H, Ueland P, Vollset S. Major lifestyle determinants of plasma total homocysteine distribution: The Hordaland homocysteine study. American Journal of Clinical Nutrition 1998;67:263–170.
Selhub J, Jacques PF, Wilson PWF, Rush D, Rosenberg IH. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. Journal of the American Medical Association 1993;270:2693–2698.
Baigent C, Clarke. 2007. B Vitamins for the prevention of vascular disease: Insufficient evidence to justify treatment. Journal of the American Medical Association 298:1212–1214.
Moore JE, Steinman BA, Giesen JM, Frank JJ. Functional outcomes and consumer satisfaction in the independent living program for older individuals who are blind. Journal of Visual Impairment and Blindness 2006;100:285–294.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Steinman, B.A., Vasunilashorn, S. Biological risk of older adults with visual impairments. J Nutr Health Aging 15, 296–302 (2011). https://doi.org/10.1007/s12603-010-0296-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-010-0296-2