Table 4.
Chronic Disease Risk Factors and Comorbidities Associated with Psychological Distress Among Adults ≥18 Years with General Vision Impairment or ≥1 Visual Function Impairment in the United States in 2016–2017
| Risk factors and comorbidities | Psychological Distress Adjusted Odds Ratio (95% Confidence Interval)a |
|||
|---|---|---|---|---|
| General Vision Impairmentb | ≥1 Visual Function Impairmentc | |||
| Mild/moderate (K6 score: 8–12) |
Serious (K6 score: 13–24) |
Mild/moderate (K6 score: 8–12) |
Serious (K6 score: 13–24) |
|
| Smoking statusd | ||||
| Not current smoker | 1.00 [Reference] | 1.00 [Reference] | 1.00 [Reference] | 1.00 [Reference] |
| Current smoker | 1.48 (1.20, 1.82) | 2.45 (1.88, 3.18) | 1.23 (0.99, 1.52) | 1.96 (1.55, 2.49) |
| Physical activitye | ||||
| Some physical activity | 1.00 [Reference] | 1.00 [Reference] | 1.00 [Reference] | 1.00 [Reference] |
| Physically inactive | 1.22 (1.00, 1.48) | 1.61 (1.22, 2.11) | 1.26 (1.03, 1.53) | 1.44 (1.13, 1.83) |
| Body mass index (kg/m2)f | ||||
| Underweight | 0.98 (0.45, 2.12) | 1.64 (0.74, 3.66) | 1.14 (0.54, 2.43) | 2.97 (1.45, 6.08) |
| Normal weight | 1.00 [Reference] | 1.00 [Reference] | 1.00 [Reference] | 1.00 [Reference] |
| Overweight | 0.94 (0.72, 1.23) | 0.94 (0.67, 1.31) | 1.01 (0.80, 1.28) | 0.99 (0.73, 1.34) |
| Obesity | 1.08 (0.84, 1.38) | 1.17 (0.86, 1.58) | 1.15 (0.88, 1.49) | 1.19 (0.88, 1.60) |
| Health conditionsg | ||||
| Diabetes | 0.98 (0.77, 1.24) | 0.92 (0.71, 1.19) | 0.90 (0.71, 1.15) | 1.08 (0.82, 1.43) |
| Hypertension | 1.39 (1.11, 1.74) | 1.29 (1.00, 1.66) | 1.23 (0.99, 1.53) | 1.46 (1.14, 1.87) |
| Arthritis | 1.50 (1.23, 1.83) | 2.18 (1.66, 2.87) | 1.60 (1.33, 1.93) | 1.76 (1.39, 2.23) |
| Coronary heart disease | 1.03 (0.70, 1.51) | 1.31 (0.82, 2.08) | 1.21 (0.86, 1.69) | 1.30 (0.89, 1.90) |
| COPD | 1.66 (1.23, 2.25) | 1.65 (1.15, 2.37) | 1.70 (1.27, 2.28) | 1.68 (1.24, 2.28) |
| Myocardial infarction | 1.11 (0.74, 1.67) | 1.25 (0.79, 1.99) | 1.07 (0.75, 1.55) | 1.39 (0.91, 2.13) |
| Stroke | 1.70 (1.26, 2.31) | 1.44 (0.99, 2.09) | 1.60 (1.18, 2.16) | 1.51 (1.07, 2.14) |
Abbreviations: COPD (chronic obstructive pulmonary disease), K6 (Kessler 6-item Psychological Distress Scale).
Multinomial logistic regression was used to calculate adjusted odds ratios for mild/moderate and serious psychological distress (reference: no/low psychological distress which is a K6 score of 0–7). Each type of vision impairment was modeled separately, and the models included all of the chronic disease risk factors and comorbidities and all of the sociodemographic characteristics (age, sex, race/ethnicity, education level, marital status, employment status, income-to-poverty ratio, and health insurance status). Multiple imputation was used to impute missing data for physical activity, body mass index, and income-to-poverty ratio. Sample sizes for each model were: general vision impairment (n=6,596) and ≥1 visual function impairment (n=7,057). Bold indicates statistical significance (95% confidence interval does not contain 1.0).
Defined as an affirmative response to the question: “Do you have trouble seeing, even when wearing glasses or contact lenses?”.
Defined as having difficulty (the task is somewhat difficult, very difficult, or the person is unable to do the task at all because of his/her eyesight) with any of these six functional tasks: 1) reading ordinary newsprint, 2) seeing up close when doing work or hobbies, 3) going down steps, stairs, or curbs in dim light, 4) driving in daytime in a familiar place, 5) noticing objects off to the side, or 6) finding object on a crowded shelf.
Current smoker was defined as those who had smoked more than 100 cigarettes in their lifetime and now smoke every day or some days.
Physically inactive was defined as performing 0 minutes per week of light, moderate, or vigorous leisure-time physical activities.
Body mass index was calculated, using self-reported data, as weight (kilograms) divided by height (meters) squared. Body mass index was classified as: underweight (BMI<18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), and obesity (BMI≥30 kg/m2).
Self-reported health conditions ascertained by asking whether respondent has ever been told by a doctor or other health professional that they had this condition.