Disparities in Vision Impairment and Eye Diseases among Early Late-Life Women: The Study of Women’s Health Across the Nation, Michigan Site

ABSTRACT

Objective: To quantify the burden of vision impairment (VI) and ocular conditions among early late-life women. Methods: Women (n = 254, mean age 66.0 years) participated in a comprehensive vision assessment. Visual acuity (VA) and ocular disorders (diabetic retinopathy, macular degeneration, hypertensive retinopathy, glaucoma and cataracts) were defined clinically. Race, economic strain and education were self-reported. Results: The prevalence of presenting VI (VA 20/40 or worse) was 11.0% and 75% of that was correctable (best-corrected VI 2.8%). Black women and those with greater economic strain or less education had a higher prevalence of presenting VI. These disparities were no longer present after considering best-corrected VI. Ocular disease prevalence ranged from 3.3% (age-related macular degeneration) to 30.2% (hypertensive retinopathy), but most participants were unaware of their ocular diagnosis. Conclusion: The discordance of presenting versus best-corrected VI and lack of knowledge of ocular conditions suggests a need for increased vision services. Access to optimal vision correction may attenuate differences across sociodemographic groups.

KEYWORDS:

• Disparities
• prevalence
• vision impairment
• women

Acknowledgments

The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH or the NIH.

Clinical Centers: University of Michigan, Ann Arbor – Carrie Karvonen-Gutierrez, PI 2021 – present, Siobán Harlow, PI 2011 – 2021, MaryFran Sowers, PI 1994-2011; Massachusetts General Hospital, Boston, MA – Sherri‐Ann Burnett‐Bowie, PI 2020 – Present; Joel Finkelstein, PI 1999 – 2020; Robert Neer, PI 1994 – 1999; Rush University, Rush University Medical Center, Chicago, IL – Imke Janssen, PI 2020 – Present; Howard Kravitz, PI 2009 – 2020; Lynda Powell, PI 1994 – 2009; University of California, Davis/Kaiser – Elaine Waetjen and Monique Hedderson, PIs 2020 – Present; Ellen Gold, PI 1994 - 2020; University of California, Los Angeles – Arun Karlamangla, PI 2020 – Present; Gail Greendale, PI 1994 - 2020; Albert Einstein College of Medicine, Bronx, NY – Carol Derby, PI 2011 – present, Rachel Wildman, PI 2010 – 2011; Nanette Santoro, PI 2004 – 2010; University of Medicine and Dentistry – New Jersey Medical School, Newark – Gerson Weiss, PI 1994 – 2004; and the University of Pittsburgh, Pittsburgh, PA – Rebecca Thurston, PI 2020 – Present; Karen Matthews, PI 1994 - 2020.

NIH Program Office: National Institute on Aging, Bethesda, MD – Rosaly Correa-de-Araujo 2020 - present; Chhanda Dutta 2016- present; Winifred Rossi 2012–2016; Sherry Sherman 1994 – 2012; Marcia Ory 1994 – 2001; National Institute of Nursing Research, Bethesda, MD – Program Officers.

Central Laboratory: University of Michigan, Ann Arbor – Daniel McConnell (Central Ligand Assay Satellite Services).

Coordinating Center: University of Pittsburgh, Pittsburgh, PA – Maria Mori Brooks, PI 2012 - present; Kim Sutton-Tyrrell, PI 2001 – 2012; New England Research Institutes, Watertown, MA - Sonja McKinlay, PI 1995 – 2001.

Steering Committee:Susan Johnson, Current Chair

Chris Gallagher, Former Chair

Acknowlegement

We thank the study staff at each site and all the women who participated in SWAN.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was additionally supported by a grant from the National Institutes of Health (NIH), DHHS, through the National Eye Institute (R21EY030363 (DCM, SEM), by the National Institute of Aging R01AG017104 (Michigan SWAN Strength & Functioning Study), and University of Michigan MCubed (SEM, CK-G). The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, and U19AG063720).