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Prevalence of visual impairment in people aged 75 years and older in Britain: results from the MRC trial of assessment and management of older people in the community
  1. J R Evans1,
  2. A E Fletcher2,
  3. R P L Wormald1,
  4. E Siu-Woon Ng2,
  5. S Stirling2,
  6. L Smeeth2,
  7. E Breeze2,
  8. C J Bulpitt3,
  9. M Nunes3,
  10. D Jones4,
  11. A Tulloch5
  1. 1Department of Epidemiology and International Eye Health, Institute of Ophthalmology, London, UK
  2. 2Centre for Ageing and Public Health, London School of Hygiene and Tropical Medicine, London, UK
  3. 3Section of Care of the Elderly, Faculty of Medicine, Imperial College, Hammersmith Campus, London, UK
  4. 4Department of Geriatric Medicine, University of Wales College of Medicine, Cardiff, UK
  5. 5General Practice Unit of Health Care Epidemiology, University of Oxford, Oxford, UK
  1. Correspondence to: Ms Jennifer Evans, Department of Epidemiology and International Eye Health, Institute of Ophthalmology, London, UK


Aims: To measure the prevalence of visual impairment in a large representative sample of people aged 75 years and over participating in the MRC trial of assessment and management of older people in the community.

Methods: 53 practices in the MRC general practice research framework. Data were obtained from 14 600 participants aged 75 years and older. Prevalence of visual impairment overall (binocular visual acuity <6/18) which was categorised separately into low vision (binocular visual acuity <6/18–3/60) or blindness (binocular visual acuity of <3/60). The prevalence of binocular acuity <6/12 was presented for comparison with other studies. Visual acuity was measured using Glasgow acuity charts; glasses, if worn, were not removed.

Results: Visual acuity was available for 14 600 people out of 21 241 invited (69%). Among people with visual acuity data, 12.4% overall (1803) were visually impaired (95% confidence intervals 10.8% to 13.9%); 1501 (10.3%) were categorised as having low vision (8.7% to 11.8%), and 302 (2.1%) were blind (1.8% to 2.4%). At ages 75–79, 6.2% of the cohort were visually impaired (5.1% to 7.3%) with 36.9% at age 90+ (32.5% to 41.3%). At ages 75–79, 0.6% (0.4% to 0.8%) of the study population were blind, with 6.9% (4.8% to 9.0%) at age 90+. In multivariate regression, controlling for age, women had significant excess risk of visual impairment (odds ratio 1.43, 95% confidence interval 1.29 to 1.58). Overall, 19.9% of study participants had a binocular acuity of less than 6/12 (17.8% to 22.0%).

Conclusion: The results from this large study show that visual impairment is common in the older population and that this risk increases rapidly with advancing age, especially for women. A relatively conservative measure of visual impairment was used. If visual impairment had been defined as visual acuity of <6/12 (American definition of visual impairment), the age specific prevalence estimates would have increased by 60%.

  • visual impairment
  • blindness
  • prevalence
  • elderly

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