Smoking and Visual Impairment Among Older Adults With Age-Related Eye Diseases -|- Preventing Chronic Disease: July 2011: 10_0156

ORIGINAL RESEARCH
Smoking and Visual Impairment Among Older Adults With Age-Related Eye Diseases

Xinzhi Zhang, MD, PhD; Jennifer Kahende, PhD; Amy Z. Fan, MD, PhD; Lawrence Barker, PhD; Theodore J. Thompson, MS; Ali H. Mokdad, PhD; Yan Li, MD, MPH; Jinan B. Saaddine, MD, MPH

Suggested citation for this article: Zhang X, Kahende J, Fan AZ, Barker L, Thompson TJ, Mokdad AH, et al. Smoking and visual impairment among older adults with age-related eye diseases. Prev Chronic Dis 2011;8(4):A84. http://www.cdc.gov/pcd/issues/2011/jul/10_0156.htm. Accessed [date].

PEER REVIEWED

Abstract
Introduction
Tobacco use is the leading preventable cause of death in the United States. Visual impairment, a common cause of disability in the United States, is associated with shorter life expectancy and lower quality of life. The relationship between smoking and visual impairment is not clearly understood. We assessed the association between smoking and visual impairment among older adults with age-related eye diseases.

Methods
We analyzed Behavioral Risk Factor Surveillance System data from 2005 through 2008 on older adults with age-related eye diseases (cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy; age ≥50 y, N = 36,522). Visual impairment was defined by self-reported difficulty in recognizing a friend across the street or difficulty in reading print or numbers. Current smokers were respondents who reported having smoked at least 100 cigarettes ever and still smoked at the time of interview. Former smokers were respondents who reported having ever smoked at least 100 cigarettes but currently did not smoke. We used multivariate logistic regressions to examine the association and to adjust for potential confounders.

Results
Among respondents with age-related eye diseases, the estimated prevalence of visual impairment was higher among current smokers (48%) than among former smokers (41%, P < .05) and respondents who had never smoked (42%, P < .05). After adjustment for age, sex, race/ethnicity, education, and general health status, current smokers with age-related eye diseases were more likely to have visual impairment than respondents with age-related eye diseases who had never smoked (odds ratio, 1.16, P < .05). Furthermore, respondents with cataract who were current smokers were more likely to have visual impairment than respondents with cataract who had never smoked (predictive margin, 44% vs 40%, P = .03), and the same was true for respondents with age-related macular degeneration (65% of current smokers vs 57% of never smokers, P = .02). This association did not hold true among respondents with glaucoma or diabetic retinopathy. Conclusion Smoking is linked to self-reported visual impairment among older adults with age-related eye diseases, particularly cataract and age-related macular degeneration. Longitudinal evaluation is needed to assess smoking cessation’s effect on vision preservation. full-text: Preventing Chronic Disease: July 2011: 10_0156


Author Information
Corresponding Author: Xinzhi Zhang, MD, PhD, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-10, Atlanta, GA 30341-3727. Telephone: 770-488-4877. E-mail: XZhang4@cdc.gov.

Author Affiliations: Jennifer Kahende, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Amy Z. Fan, Yan Li, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Lawrence Barker, Theodore J. Thompson, Jinan B. Saaddine, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Ali H. Mokdad, Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington.

INVESTIGACIÓN ORIGINAL
Tabaquismo y pérdida de la vista en adultos mayores con enfermedades oculares relacionadas a la edad

Xinzhi Zhang, MD, PhD; Jennifer Kahende, PhD; Amy Z. Fan, MD, PhD; Lawrence Barker, PhD; Theodore J. Thompson, MS; Ali H. Mokdad, PhD; Yan Li, MD, MPH; Jinan B. Saaddine, MD, MPH

Suggested citation for this article: Zhang X, Kahende J, Fan AZ, Barker L, Thompson TJ, Mokdad AH, et al. Tabaquismo y pérdida de la vista en adultos mayores con enfermedades oculares relacionadas a la edad. Prev Chronic Dis 2011;8(4):A84.
http://www.cdc.gov/pcd/issues/2011/jul/10_0156_es.htm. Consulta: [fecha].

REVISADO POR EXPERTOS

Resumen
Introducción
El consumo de tabaco es la causa principal de muerte prevenible en los Estados Unidos. La pérdida de la vista, una causa frecuente de discapacidad en los Estados Unidos, está asociada a una esperanza de vida más corta y a una menor calidad de vida. La relación entre tabaquismo y pérdida de la vista no se ha comprendido del todo. Evaluamos la asociación entre tabaquismo y pérdida de la vista en adultos mayores con enfermedades oculares relacionadas a la edad.

Métodos
Analizamos datos del Sistema de Vigilancia de Factores de Riesgo del Comportamiento (BRFSS) del 2005 al 2008 sobre los adultos mayores con enfermedades oculares relacionadas a la edad (cataratas, glaucoma, generación macular atribuida a la edad y retinopatía diabética; de ≥50 de edad y N = 36,522). La pérdida de la vista se definió como la dificultad autorreportada para reconocer a un amigo al otro lado de la calle o dificultad para leer letras o números. Los fumadores actuales eran participantes que reportaron haber fumado al menos 100 cigarrillos o que todavía fumaban al momento de la entrevista. Los participantes ex fumadores reportaron que alguna vez fumaron al menos 100 cigarrillos pero en la actualidad no fumaban. Usamos modelos de regresión logística multivariada para analizar la asociación y ajustar por posibles factores de confusión.

Resultados
Entre los participantes con enfermedades oculares relacionadas a la edad, la prevalencia estimada de pérdida de la vista era más alta en los fumadores actuales (48%) que en los ex fumadores (41%, P < .05) y los participantes que nunca fumaron (42%, P < .05). Después de ajustar por edad, raza o grupo étnico, nivel educativo y estado de salud en general, los fumadores actuales con enfermedades oculares relacionadas a la edad tenían una mayor probabilidad de sufrir pérdida de la vista que los que tenían dichas enfermedades y nunca habían fumado (razón de probabilidad, 1.16, P < .05). Además, los participantes con cataratas que eran fumadores actuales tenían una probabilidad mayor de sufrir pérdida de la vista que los participantes con cataratas que nunca habían fumado (margen de predicción 44% frente a 40%, P = .03), y lo mismo ocurría con los participantes con degeneración macular atribuida a la edad (65% de los fumadores actuales frente a 57% de los que nunca fumaron, P = .02). Esta asociación no se aplicó a los participantes con glaucoma o retinopatía diabética.

Conclusión
El tabaquismo está vinculado a la pérdida de la vista autorreportada en los adultos mayores con enfermedades oculares relacionadas a la edad, en especial degeneración macular atribuida a la edad. Es necesario realizar una evaluación longitudinal para determinar el efecto de la cesación del tabaco en la preservación de la vista.