Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1999 Aug;89(8):1200–1205. doi: 10.2105/ajph.89.8.1200

Prevalence of self-rated visual impairment among adults with diabetes.

J B Saaddine 1, K M Narayan 1, M M Engelgau 1, R E Aubert 1, R Klein 1, G L Beckles 1
PMCID: PMC1508683  PMID: 10432906

Abstract

OBJECTIVES: This study estimated the prevalence of self-rated visual impairment among US adults with diabetes and identified correlates of such impairment. METHODS: Self-reported data from the 1995 Behavioral Risk Factor Surveillance System survey of adults 18 years and older with diabetes were analyzed. Correlates of visual impairment were examined by multiple logistic regression analysis. RESULTS: The prevalence of self-rated visual impairment was 24.8% (95% confidence interval [CI] = 22.3%, 27.3%). Among insulin users, multivariable-adjusted odds ratios were 4.9 (95% CI = 2.6, 9.2) for those who had not completed high school and 1.8 (95% CI = 1.0, 2.8) for those who had completed high school compared with those with higher levels of education. Comparable estimates of odds ratios for nonusers of insulin were 2.2 (95% CI = 1.4, 3.4) and 1.3 (95% CI = 0.9, 2.0), respectively. Among nonusers, the adjusted odds for minority adults were 2.4 (95% CI = 1.0, 3.7) times the odds for non-Hispanic Whites. CONCLUSIONS: By these data, 1.6 million US adults with diabetes reported having some degree of visual impairment. Future research on the specific causes of visual impairment may help in estimating the avoidable public health burden.

Full text

PDF
1200

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ammons L. Demographic profile of health-care coverage in America in 1993. J Natl Med Assoc. 1997 Nov;89(11):737–744. [PMC free article] [PubMed] [Google Scholar]
  2. Asimakis P., Coster D. J., Lewis D. J. Cost effectiveness of cataract surgery. A comparison of conventional extracapsular surgery and phacoemulsification at Flinders Medical Centre. Aust N Z J Ophthalmol. 1996 Nov;24(4):319–325. doi: 10.1111/j.1442-9071.1996.tb01602.x. [DOI] [PubMed] [Google Scholar]
  3. Bowlin S. J., Morrill B. D., Nafziger A. N., Jenkins P. L., Lewis C., Pearson T. A. Validity of cardiovascular disease risk factors assessed by telephone survey: the Behavioral Risk Factor Survey. J Clin Epidemiol. 1993 Jun;46(6):561–571. doi: 10.1016/0895-4356(93)90129-o. [DOI] [PubMed] [Google Scholar]
  4. Bowlin S. J., Morrill B. D., Nafziger A. N., Lewis C., Pearson T. A. Reliability and changes in validity of self-reported cardiovascular disease risk factors using dual response: the behavioral risk factor survey. J Clin Epidemiol. 1996 May;49(5):511–517. doi: 10.1016/0895-4356(96)00010-8. [DOI] [PubMed] [Google Scholar]
  5. Brechner R. J., Cowie C. C., Howie L. J., Herman W. H., Will J. C., Harris M. I. Ophthalmic examination among adults with diagnosed diabetes mellitus. JAMA. 1993 Oct 13;270(14):1714–1718. [PubMed] [Google Scholar]
  6. Bush T. L., Miller S. R., Golden A. L., Hale W. E. Self-report and medical record report agreement of selected medical conditions in the elderly. Am J Public Health. 1989 Nov;79(11):1554–1556. doi: 10.2105/ajph.79.11.1554. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Chiang Y. P., Wang F., Javitt J. C. Office visits to ophthalmologists and other physicians for eye care among the U.S. population, 1990. Public Health Rep. 1995 Mar-Apr;110(2):147–153. [PMC free article] [PubMed] [Google Scholar]
  8. Cohen D. L., Neil H. A., Thorogood M., Mann J. I. A population-based study of the incidence of complications associated with type 2 diabetes in the elderly. Diabet Med. 1991 Dec;8(10):928–933. doi: 10.1111/j.1464-5491.1991.tb01532.x. [DOI] [PubMed] [Google Scholar]
  9. Dana M. R., Tielsch J. M., Enger C., Joyce E., Santoli J. M., Taylor H. R. Visual impairment in a rural Appalachian community. Prevalence and causes. JAMA. 1990 Nov 14;264(18):2400–2405. [PubMed] [Google Scholar]
  10. Dargent-Molina P., Favier F., Grandjean H., Baudoin C., Schott A. M., Hausherr E., Meunier P. J., Bréart G. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet. 1996 Jul 20;348(9021):145–149. doi: 10.1016/s0140-6736(96)01440-7. [DOI] [PubMed] [Google Scholar]
  11. Ferris F. L., 3rd How effective are treatments for diabetic retinopathy? JAMA. 1993 Mar 10;269(10):1290–1291. [PubMed] [Google Scholar]
  12. Fryback D. G., Dasbach E. J., Klein R., Klein B. E., Dorn N., Peterson K., Martin P. A. The Beaver Dam Health Outcomes Study: initial catalog of health-state quality factors. Med Decis Making. 1993 Apr-Jun;13(2):89–102. doi: 10.1177/0272989X9301300202. [DOI] [PubMed] [Google Scholar]
  13. Hiller R., Krueger D. E. Validity of a survey question as a measure of visual acuity impairment. Am J Public Health. 1983 Jan;73(1):93–96. doi: 10.2105/ajph.73.1.93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Javitt J. C., Aiello L. P. Cost-effectiveness of detecting and treating diabetic retinopathy. Ann Intern Med. 1996 Jan 1;124(1 Pt 2):164–169. doi: 10.7326/0003-4819-124-1_part_2-199601011-00017. [DOI] [PubMed] [Google Scholar]
  15. Javitt J. C., Brenner M. H., Curbow B., Legro M. W., Street D. A. Outcomes of cataract surgery. Improvement in visual acuity and subjective visual function after surgery in the first, second, and both eyes. Arch Ophthalmol. 1993 May;111(5):686–691. doi: 10.1001/archopht.1993.01090050120041. [DOI] [PubMed] [Google Scholar]
  16. Kehoe R., Wu S. Y., Leske M. C., Chylack L. T., Jr Comparing self-reported and physician-reported medical history. Am J Epidemiol. 1994 Apr 15;139(8):813–818. doi: 10.1093/oxfordjournals.aje.a117078. [DOI] [PubMed] [Google Scholar]
  17. Klein B. E., Klein R. Protecting vision. N Engl J Med. 1995 May 4;332(18):1228–1229. doi: 10.1056/NEJM199505043321811. [DOI] [PubMed] [Google Scholar]
  18. Klein R., Klein B. E., Jensen S. C., Moss S. E., Cruickshanks K. J. The relation of socioeconomic factors to age-related cataract, maculopathy, and impaired vision. The Beaver Dam Eye Study. Ophthalmology. 1994 Dec;101(12):1969–1979. doi: 10.1016/s0161-6420(13)31077-x. [DOI] [PubMed] [Google Scholar]
  19. Klein R., Klein B. E., Jensen S. C., Moss S. E. The relation of socioeconomic factors to the incidence of proliferative diabetic retinopathy and loss of vision. Ophthalmology. 1994 Jan;101(1):68–76. doi: 10.1016/s0161-6420(94)31354-6. [DOI] [PubMed] [Google Scholar]
  20. Klein R., Klein B. E., Moss S. E. Visual impairment in diabetes. Ophthalmology. 1984 Jan;91(1):1–9. [PubMed] [Google Scholar]
  21. Klein R., Moss S. E., Klein B. E., DeMets D. L. Relation of ocular and systemic factors to survival in diabetes. Arch Intern Med. 1989 Feb;149(2):266–272. [PubMed] [Google Scholar]
  22. Kriegsman D. M., Penninx B. W., van Eijk J. T., Boeke A. J., Deeg D. J. Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy. J Clin Epidemiol. 1996 Dec;49(12):1407–1417. doi: 10.1016/s0895-4356(96)00274-0. [DOI] [PubMed] [Google Scholar]
  23. Lee P. P., Whitcup S. M., Hays R. D., Spritzer K., Javitt J. The relationship between visual acuity and functioning and well-being among diabetics. Qual Life Res. 1995 Aug;4(4):319–323. doi: 10.1007/BF01593884. [DOI] [PubMed] [Google Scholar]
  24. Marseille E. Cost-effectiveness of cataract surgery in a public health eye care programme in Nepal. Bull World Health Organ. 1996;74(3):319–324. [PMC free article] [PubMed] [Google Scholar]
  25. Midthjell K., Holmen J., Bjørndal A., Lund-Larsen G. Is questionnaire information valid in the study of a chronic disease such as diabetes? The Nord-Trøndelag diabetes study. J Epidemiol Community Health. 1992 Oct;46(5):537–542. doi: 10.1136/jech.46.5.537. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Moss S. E., Klein R., Klein B. E. Ten-year incidence of visual loss in a diabetic population. Ophthalmology. 1994 Jun;101(6):1061–1070. doi: 10.1016/s0161-6420(94)31217-6. [DOI] [PubMed] [Google Scholar]
  27. Podgor M. J., Cassel G. H., Kannel W. B. Lens changes and survival in a population-based study. N Engl J Med. 1985 Dec 5;313(23):1438–1444. doi: 10.1056/NEJM198512053132303. [DOI] [PubMed] [Google Scholar]
  28. Salive M. E., Guralnik J., Glynn R. J., Christen W., Wallace R. B., Ostfeld A. M. Association of visual impairment with mobility and physical function. J Am Geriatr Soc. 1994 Mar;42(3):287–292. doi: 10.1111/j.1532-5415.1994.tb01753.x. [DOI] [PubMed] [Google Scholar]
  29. Scott I. U., Schein O. D., West S., Bandeen-Roche K., Enger C., Folstein M. F. Functional status and quality of life measurement among ophthalmic patients. Arch Ophthalmol. 1994 Mar;112(3):329–335. doi: 10.1001/archopht.1994.01090150059023. [DOI] [PubMed] [Google Scholar]
  30. Shea S., Stein A. D., Lantigua R., Basch C. E. Reliability of the behavioral risk factor survey in a triethnic population. Am J Epidemiol. 1991 Mar 1;133(5):489–500. doi: 10.1093/oxfordjournals.aje.a115916. [DOI] [PubMed] [Google Scholar]
  31. Stein A. D., Courval J. M., Lederman R. I., Shea S. Reproducibility of responses to telephone interviews: demographic predictors of discordance in risk factor status. Am J Epidemiol. 1995 Jun 1;141(11):1097–1105. doi: 10.1093/oxfordjournals.aje.a117375. [DOI] [PubMed] [Google Scholar]
  32. Stein A. D., Lederman R. I., Shea S. The Behavioral Risk Factor Surveillance System questionnaire: its reliability in a statewide sample. Am J Public Health. 1993 Dec;83(12):1768–1772. doi: 10.2105/ajph.83.12.1768. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Steinberg E. P., Tielsch J. M., Schein O. D., Javitt J. C., Sharkey P., Cassard S. D., Legro M. W., Diener-West M., Bass E. B., Damiano A. M. The VF-14. An index of functional impairment in patients with cataract. Arch Ophthalmol. 1994 May;112(5):630–638. doi: 10.1001/archopht.1994.01090170074026. [DOI] [PubMed] [Google Scholar]
  34. Tielsch J. M., Sommer A., Witt K., Katz J., Royall R. M. Blindness and visual impairment in an American urban population. The Baltimore Eye Survey. Arch Ophthalmol. 1990 Feb;108(2):286–290. doi: 10.1001/archopht.1990.01070040138048. [DOI] [PubMed] [Google Scholar]
  35. Will J. C., German R. R., Schuman E., Michael S., Kurth D. M., Deeb L. Patient adherence to guidelines for diabetes eye care: results from the diabetic eye disease follow-up study. Am J Public Health. 1994 Oct;84(10):1669–1671. doi: 10.2105/ajph.84.10.1669. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES