Impact of functional blindness and visual impairment on health outcomes in older Mexican Americans

This study examined the extent of reduced visual acuity and its effects on subsequent health outcomes among 3,050 non-institutionalized Mexican Americans, 65 years of age or older based on data from the Hispanic Established Population for Epidemiologic Studies of the Elderly (Hispanic EPESE. Baseline data was collected by face-to-face interviews during 1993 and 1994. Prospective analysis included data collected for three follow-up interviews at 2- (1995--96), 5- (1998--99) and 7-years (2000--01).; Usual-corrected bilateral distance visual acuity was assessed using a modified Snellen test method. Visual acuity categories were defined according to vision measurement criteria consistent with other Established Population for Epidemiologic Studies of the Elderly (EPESE) surveys. Functional blindness (FB) referred to severely impaired vision based on subject self-reported blindness or visual acuity worse than 20/200. Visual impairment (VI) referred to visual acuity between <20/40 and 20/200.; Baseline analysis revealed the prevalence of FB was greater among older Mexican Americans (8.1%) compared to the general population as reported for other EPESE studies (4.6%). Baseline FB was associated with subject age, former alcohol consumption, not being married and having physician-reported diabetes or cardiovascular disease. Subjects 75 years of age or older and those with baseline hypertension or diabetes were also at greater odds for baseline VI. Males and subjects with baseline diabetes were at greater risk of FB 2-years after baseline. Logistic regression analyses showed that VI was associated with baseline depressive symptoms, whereas those with FB were more likely to have mobility limitations, hip fractures, falls, and reduced activity level. Longitudinal analyses using Cox Proportional Hazard models showed that FB was associated with 5- and 7-year all-cause mortality, whereas VI was independently associated with 7-year incidence of vision disability after controlling for other risk factors.; This study suggests that older Mexican Americans are at risk for severely impaired vision which can negatively impact subsequent health outcomes, including higher risk for mortality and increased risk of disability over time among those with moderate visual impairment.