Association between visual impairment and recurrent hospitalizations in older US adults

Niranjani Nagarajan; Karolina Leziak; Yunshu Zhou; Rachel Mumby; Mengyao Hu; Lauren E Ferrante; Lindsey B De Lott; David B Rein; Joshua R Ehrlich

doi:10.1111/jgs.19308

Association between visual impairment and recurrent hospitalizations in older US adults

J Am Geriatr Soc. 2024 Dec 9. doi: 10.1111/jgs.19308. Online ahead of print.

Authors

Niranjani Nagarajan¹, Karolina Leziak², Yunshu Zhou³, Rachel Mumby³, Mengyao Hu³, Lauren E Ferrante⁴, Lindsey B De Lott¹, David B Rein⁵, Joshua R Ehrlich^{1

3}

Affiliations

¹ Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.
² University of Michigan Medical School, Ann Arbor, Michigan, USA.
³ Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
⁴ Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
⁵ National Opinion Research Center, Atlanta, Georgia, USA.

PMID: 39653643
DOI: 10.1111/jgs.19308

Abstract

Background: Visual impairment (VI) is common in older adults and is associated with adverse health outcomes. However, the association between objectively assessed VI and recurrent hospitalization remains unclear.

Objective: To investigate the association of different domains of visual function with recurrent hospitalization in older adults in the United States.

Methods: We used data from Round 11 of the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries, which included objective measures of distance and near visual acuity and contrast sensitivity. Using multivariable logistic regression models, we analyzed the association between VI (distance and near acuity <20/40, contrast sensitivity <1 SD below the sample mean) and prior year hospitalization and estimated marginal predicted probabilities of any (≥1) and recurrent (>1) hospitalization. Models were adjusted for demographic factors and comorbid medical conditions and accounted for NHATS complex survey design.

Results: The sample included 2960 respondents aged 71 and older (median age 81 years; 45% male, 82% non-Hispanic White). The predicted probability of hospitalization for those with any type of VI was 19.2% (15.9-22.6) versus 16.7% (14.9-18.6) for those without VI. The predicted probability of recurrent hospitalization for those with any type of VI was 7.2% (4.8-9.7) versus 4.1% (3.1-5.2) for those without VI. Near VI was significantly associated with recurrent hospitalization (OR = 2.04 [1.6, 3.61], p = 0.02), independent of other visual function measures, while other types of VI were not.

Conclusion: Near VI is significantly associated with recurrent hospitalization in older US adults. Future studies should determine whether improving near vision affects the likelihood of recurrent hospitalization.

Keywords: National Health and Aging Trends Study; gerontology; hospitalizations; older adults; visual impairment.

Abstract

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