Vision-related quality of life impact of age-related macular degeneration in older adults aged 60-100 years: a cross-sectional study.

Abstract

We evaluated the prevalence of age-related macular degeneration (AMD) and its interplay with age in influencing vision-related quality of life (VRQoL) in older Asians. We included 2361 participants aged 60-101 years from the Population Health and Eye Disease Profile in Elderly Singaporeans cross-sectional study (2017-2022). Early and late AMD were graded using the modified Wisconsin grading system. VRQoL was assessed using Rasch-transformed overall, visual functioning and emotional well-being scores of the Brief Impact of Visual Impairment questionnaire. We calculated the prevalence of AMD and used multivariable regression models to assess the associations between AMD and age on VRQoL. VRQoL reduction was deemed clinically meaningful if ≥0.5 SD of the cohort's baseline VRQoL scores. The overall prevalence of any, early and late AMD was 6.2%, 4.4% and 1.8%, respectively. The age-specific prevalence increased progressively with age; that is, any AMD (4.1%, 7.2%, 12.9%), early AMD (3.0%, 4.7%, 9.3%) and late AMD (1.1%, 2.5%, 3.5%) across the three age groups (60-79, 70-79 and 80+), respectively. Participants aged ≥80 with late AMD experienced 30.1%, 21.0% and 29.7% poorer overall, visual functioning and emotional well-being, respectively (all p≤0.001), compared with those aged 60-79 without AMD. Importantly, only those aged ≥80 with late AMD demonstrated both statistically and clinically meaningful VRQoL reductions. AMD is prevalent in ageing Asians and has a substantial impact on visual functioning and emotional well-being. Our findings support early detection of declining visual functioning and mental health and strategies to prevent progression to late-stage AMD in older patients.