Non-standard Vision Measures Predict Mortality in Elders: The Smith-Kettlewell Institute (SKI) Study

Abstract

Purpose: To determine which vision tests predict mortality within 10 years in a community-based elderly sample.

Methods: Nine hundred residents of Marin County, California 58 to 101 years of age (mean 75 years at baseline), underwent a battery of tests, including high contrast acuity, low contrast acuity, low contrast/low luminance acuity, acuity in glare, contrast sensitivity, color vision, stereopsis, standard and attentional fields. The association between the vision tests and mortality within 10 years of baseline was assessed with Cox Proportional Hazards models controlling for age, sex, education level, depression, cognitive status and self-reported medical conditions.

Results: Forty-three percent of the sample died within 10 years of baseline. When controlling for mortality-related covariates, impairment in any of the vision measures was associated with increased risk of death. However, non-standard vision measures (ie, impairment in low contrast/low luminance acuity, standard field integrity and the impact of the attentional task on field integrity) were more highly associated with mortality than standard high contrast acuity.

Conclusions: In agreement with other studies, we find that visual impairment is a significant predictor of death. However, the strongest relationship was found for measures other than high contrast acuity. These results suggest that non-standard vision measures may be more sensitive indicators of generalized aging in the most elderly.

KEYWORDS::

• Aging
• Attentional visual fields
• Mortality
• SKILL Dark Acuity
• Visual impairment

ACKNOWLEDGMENTS

We are deeply grateful to Ruth Youngquist, the volunteers from The Buck Institute for Age Research, and the SKI Study participants. This research was supported by a National Institute of Health (NIH) Grant EY09588 to John Brabyn and by the Smith-Kettlewell Eye Research Institute. These results were presented, in part, at the Association for Research in Vision and Ophthalmology, 2006 in Ft. Lauderdale, FL.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.