Near Visual Impairment Incidence in Relation to Diabetes in Older People: The Three-Cities Study - American Geriatric Society

Objectives

To characterize the relationship between diabetes mellitus (DM) and future risk of near vision impairment (VI) in a community-dwelling population of older people.

Design

Seven-year population-based longitudinal study.

Setting

Three-Cities Study, a French prospective study designed to assess the risk of cognitive and functional decline attributable to vascular factors.

Participants

Community-dwelling individuals aged 65 and older (N = 8,412).

Measurements

DM was determined at baseline according to self-reported DM, antidiabetic treatment, and fasting blood glucose. Near visual acuity was measured at baseline and 2, 4, and 7 years later. Near VI was defined as a Snellen score greater than 20/30.

Results

DM was associated with a higher risk of near VI in an adjusted model (hazard ratio (HR) = 1.24, 95% confidence interval (CI) = 1.02–1.52, P = .03). Because of an interaction between Body Mass Index (BMI) and diagnosed DM, the longitudinal analyses were stratified according to BMI category. DM was associated with greater risk of near VI only in underweight (BMI <21.0 kg/m², HR = 2.89, 95% CI = 1.18–7.03) and normal-weight (BMI 21.0–24.9 kg/m², HR = 1.60, 95% CI = 1.10–2.32), but not overweight (P = .69) and obese (P = .09) subjects.

Conclusion

DM is a risk factor for near VI in older people, particularly in those with a low or normal BMI. This risk profile should be taken into account in older adults to support their independence.

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