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Prevalence of nonrefractive visual impairment in US adults and associated risk factors, 1999-2002 and 2005-2008.

ABSTRACT: CONTEXT:Over the past decade, chronic illnesses with ophthalmic sequelae such as diabetes and diabetic retinopathy have increased. OBJECTIVES:To estimate prevalence of nonrefractive visual impairment and to describe its relationship with demographic and systemic risk factors including diagnosed diabetes. DESIGN, SETTING, AND PARTICIPANTS:The National Health and Nutrition Examination Survey (NHANES) examined a representative sample of the US noninstitutionalized population. In 1999-2002 and 2005-2008, 9471 and 10,480 participants aged 20 years or older received questionnaires, laboratory tests, and physical examinations. Visual acuity of less than 20/40 aided by autorefractor was classified as nonrefractive visual impairment. MAIN OUTCOME MEASURE:Nonrefractive visual impairment. RESULTS:Weighted prevalence of nonrefractive visual impairment increased 21% among US adults aged 20 years and older from 1.4% in 1999-2002 to 1.7% in 2005-2008 (P = .03); and increased 40% among non-Hispanic whites aged 20-39 years from 0.5% to 0.7% (P = .008). In multivariable analyses, statistically significant risk factors for nonrefractive visual impairment in 1999-2002 included age (per year odds ratio [OR], 1.07; 95% CI, 1.05-1.09), poverty (OR, 2.18; 95% CI, 1.31-3.64), lack of insurance (OR, 1.85; 95% CI, 1.16-2.95), and diabetes with 10 or more years since diagnosis (OR, 1.93; 95% CI, 1.15-3.25). In 2005-2008, risk factors included age (OR, 1.05; 95% CI, 1.04-1.07), poverty (OR, 2.23; 95% CI, 1.55-3.22), education less than high school (OR, 2.11; 95% CI, 1.54-2.90), and diabetes with 10 or more years since diagnosis (OR, 2.67; 95% CI, 1.64-4.37). Prevalence of diabetes with 10 or more years since diagnosis increased 22% overall from 2.8% to 3.6% (P = .02); and 133% among non-Hispanic whites aged 20-39 years from 0.3% to 0.7% (P < .001). CONCLUSION:Prevalence of nonrefractive visual impairment was significantly higher in 2005-2008 than in 1999-2002 and may be attributable, in part, to higher prevalence of diabetes, an associated risk factor that increased in prevalence during this time period.

SUBMITTER: Ko F

PROVIDER: S-EPMC3810182 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Prevalence of nonrefractive visual impairment in US adults and associated risk factors, 1999-2002 and 2005-2008.

Ko Fang F Vitale Susan S Chou Chiu-Fang CF Cotch Mary Frances MF Saaddine Jinan J Friedman David S DS

JAMA 20121201 22

<h4>Context</h4>Over the past decade, chronic illnesses with ophthalmic sequelae such as diabetes and diabetic retinopathy have increased.<h4>Objectives</h4>To estimate prevalence of nonrefractive visual impairment and to describe its relationship with demographic and systemic risk factors including diagnosed diabetes.<h4>Design, setting, and participants</h4>The National Health and Nutrition Examination Survey (NHANES) examined a representative sample of the US noninstitutionalized population. ...[more]

PMID: 23232894

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Project description:ImportanceUnderstanding population-wide trends in prevalence and control of diabetes is critical to planning public health approaches for prevention and management of the disease.ObjectiveTo determine trends in prevalence of diabetes and control of risk factors in diabetes among US adults between 1999-2000 and 2017-2018.Design, setting, and participantsTen cycles of cross-sectional National Health and Nutrition Examination Survey (NHANES) data between 1999-2000 and 2017-2018 were included. The study samples were weighted to be representative of the noninstitutionalized civilian resident US population. Adults aged 18 years or older were included, except pregnant women.ExposuresSurvey cycle.Main outcomes and measuresDiabetes was defined by self-report of diabetes diagnosis, fasting plasma glucose level of 126 mg/dL or more, or hemoglobin A1c (HbA1c) level of 6.5% or more. Three risk factor control goals were individualized HbA1c targets, blood pressure less than 130/80 mm Hg, and low-density lipoprotein cholesterol level less than 100 mg/dL. Prevalence of diabetes and proportion of adults with diagnosed diabetes who achieved risk factor control goals, overall and by sociodemographic variables, were estimated.ResultsAmong the 28 143 participants included (weighted mean age, 48.2 years; 49.3% men), the estimated age-standardized prevalence of diabetes increased significantly from 9.8% (95% CI, 8.6%-11.1%) in 1999-2000 to 14.3% (95% CI, 12.9%-15.8%) in 2017-2018 (P for trend < .001). From 1999-2002 to 2015-2018, the estimated age-standardized proportion of adults with diagnosed diabetes who achieved blood pressure less than 130/80 mm Hg (P for trend = .007) and low-density lipoprotein cholesterol level less than 100 mg/dL (P for trend < .001) increased significantly, but not individualized HbA1c targets (P for trend = .51). In 2015-2018, 66.8% (95% CI, 63.2%-70.4%), 48.2% (95% CI, 44.6%-51.8%), and 59.7% (95% CI, 54.2%-65.2%) of adults with diagnosed diabetes achieved individualized HbA1c targets, blood pressure less than 130/80 mm Hg, and low-density lipoprotein cholesterol level less than 100 mg/dL, respectively. Only 21.2% of these adults (95% CI, 15.5%-26.8%) achieved all 3. During the entire study period, these 3 goals were significantly less likely to be achieved among young adults aged 18 to 44 years (vs older adults ≥65 years: estimated proportion, 7.4% vs 21.7%; adjusted odds ratio, 0.32 [95% CI, 0.16-0.63]), non-Hispanic Black adults (vs non-Hispanic White adults: estimated age-standardized proportion, 12.5% vs 20.6%; adjusted odds ratio, 0.60 [95% CI, 0.40-0.90]), and Mexican American adults (vs non-Hispanic White adults: estimated age-standardized proportion, 10.9% vs 20.6%; adjusted odds ratio, 0.48 [95% CI, 0.31-0.77]).Conclusions and relevanceBased on NHANES data from US adults, the estimated prevalence of diabetes increased significantly between 1999-2000 and 2017-2018. Only an estimated 21% of adults with diagnosed diabetes achieved all 3 risk factor control goals in 2015-2018.

Project description:To investigate knee pain prevalence, associated factors, and functional impairment among adolescents.This was a cross-sectional study conducted between May and June 2014 with a random sample of 619 adolescents aged between 10 and 17 years. Knee pain prevalence was investigated using the Nordic Questionnaire for Osteomuscular Symptoms and a number of independent variables (demographic data, nutritional status, form of carrying backpacks, and pain during and after walking) obtained by self-report questionnaires. Physical impairment of the knee was assessed using the Brazilian version of the Knee injury and Osteoarthritis Outcome Score questionnaire. Poisson regression analysis was used to estimate the ratios of crude and adjusted knee pain association with the investigated factors. ANOVA and Kruskal-Wallis tests were used to compare median functional impairment.Knee pain prevalence over the last 7 days was 22.6%. Factors having significant association with the outcome were: being between 12 and 14 years old (PR: 1.67; 95% CI: 1.07-2.58; p<0.01), being between 15 and 17 years old (PR: 2.44; 95% CI: 1.51-3.94; p=0.01), and not doing physical education at school (PR: 0.54; 95% CI: 0.35-0.82; p=0.01). Total functional capacity among adolescents with pain was significantly lower among girls (68.7 points; PD±15.1) when compared with boys (74.3 points; PD±12.7) (p=0.02). The mean value of disabling pain was lower (55.1 points; PD±12.3) among adolescents who were physically active in their leisure time compared to those who were insufficiently active (60.4 points; PD±12.4) (p=0.02).The results of this study show that knee pain among adolescents with no previous history should be investigated, particularly among older adolescents who do not have physical education at school, since it is highly prevalent and can result in functional impairment. Regarding functionality, more attention should be given to girls and adolescents who were physically active in their leisure time.

Dataset Information

Prevalence of nonrefractive visual impairment in US adults and associated risk factors, 1999-2002 and 2005-2008.

Publications

Prevalence of nonrefractive visual impairment in US adults and associated risk factors, 1999-2002 and 2005-2008.

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