Prevalence of Chronic Health Conditions by Vision Difficulty Status Among Middle-Aged and Older Adults, United States, 2020-2024.

Choi, Jeong Ha Steph; Carlson, Susan A; Pavkov, Meda E; Pierce, Samantha L; Puckett, Mary; Omura, John D · Am J Ophthalmol · 2026

cross_sectional · Level IV

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Abstract

Examine the prevalence of select chronic health conditions by self-reported vision difficulty status among middle-aged and older adults in the United States. Cross-sectional, population-based analysis. U.S. adults aged ≥45 years. Self-reported data were from the 2020 to 2024 National Health Interview Survey (N = 85,026). Conditions included self-reported hypertension, heart disease, high cholesterol, stroke, arthritis, cancer, weak/failing kidneys, dementia, diabetes, depression, and obesity. Adjusted prevalence ratios (APRs) were estimated using multivariable logistic regression models for each condition by vision difficulty status (none, some, severe) stratified by age group (45-64, ≥65 years). Unadjusted and adjusted prevalence and APRs of 11 chronic health conditions by vision difficulty status. Overall, 20.2% of adults aged ≥45 years reported some vision difficulty and 2.1% reported severe vision difficulty. Among adults aged 45 to 64 years, the adjusted prevalences of most chronic conditions were higher among those with some or severe vision difficulty compared to those with no vision difficulty. For example, the adjusted prevalence of hypertension was 32.9% (95% confidence interval [CI]: 31.0-34.5) among those with no vision difficulty compared to 47.8% (95% CI: 42.4-53.2) among those with severe vision difficulty, with an APR of 1.45 (95% CI: 1.32-1.60). Similar patterns were observed among adults aged ≥65 years. Our findings highlight the importance of integrating vision health into chronic disease prevention and management strategies, considering the condition type, severity of vision difficulty and age when developing and tailoring these strategies.

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