Original articleAge-related macular degeneration causing visual impairment in people 75 years or older in Britain: An add-on study to the Medical Research Council Trial of Assessment and Management of Older People in the Community☆
Section snippets
Materials and methods
The MRC Trial of the Assessment and Management of Older People in the Community is a large-cluster randomized trial taking place in 106 general practices from the MRC General Practice Research Framework.8 The practices in the study were selected to be representative of the mortality (standardized mortality ratio) and Jarman scores of general practices in Britain (England, Wales, and Scotland). All patients 75 years or older on the general practitioner list were invited to participate in the
Results
Response rates for visual acuity testing have been published elsewhere.6 Briefly, there were 21 241 eligible people in 53 general practices. Of these, 15 126 (71%) had a detailed health assessment. People taking part in the study had ages (median age, 80.3 years [interquartile range, 77.2–84.2]) similar to those not taking part (median age, 81.0 [interquartile range, 77.7–85.2]).
Details of the causes of visual impairment study have been published previously.7 In brief, practices taking part in
Discussion
We estimate that 3.7% (95% CI, 3.2%–4.2%) of the population 75 years or older has AMD causing visual impairment. The prevalence increases rapidly with increasing age—14.4% (11.6%–17.2%) of the population 90 years or older are visually impaired due to AMD. Applying the age-specific prevalence rates to the United Kingdom population gives an estimated 192 000 people 75 years or older visually impaired due to AMD in the United Kingdom (95% CIs, 144 000–239 000).
The MRC Trial of the Assessment and
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2016, Progress in Retinal and Eye ResearchCitation Excerpt :AMD is characterized by central visual loss due to degenerative and neovascular alteration in the macular region of the retina (Gehrs et al., 2006). AMD is the predominant cause of blindness in developed countries (Evans et al., 2004). It is becoming similarly important in the developing world in association with increasing longevity and Westernisation of diet and lifestyle (Krishnan et al., 2010).
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2016, Survey of OphthalmologyCitation Excerpt :Age-related macular degeneration (AMD), a chronic and progressive retinal degenerative disease that manifests as impairment of central vision as a result of dysfunction and/or death of the photoreceptors and retinal pigment epithelium (RPE),8,59 is one of the main causes of visual impairment and legal blindness in the older age group.27
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2014, Journal of Dairy ScienceCitation Excerpt :The consumption of lutein has been associated with a decrease and prevention of the occurrence of cataracts and age-related macular degeneration, and hence research on the properties of this carotenoid has been increasing in recent decades (Landrum et al., 1997; Bhosale et al., 2009). Age-related macular degeneration is the main cause of irreversible blindness in the elderly and affects about 50 million people over 75 yr of age throughout the world, including more than 10 million in the United States and more than 190,000 in the United Kingdom (Evans et al., 2004; Klein et al., 2004). The ingestion of 6 mg of lutein per day has been related to a decrease of more than 43% in the risk of age-related macular degeneration (Seddon et al., 1994).
Long-term changes in visual acuity in an older population over a 15-year period: The Blue Mountains Eye Study
2013, OphthalmologyCitation Excerpt :The higher incidence of VI and blindness in the oldest age group is consistent with higher prevalence rates of macular degeneration and cataract26,27 in this age group. Consistent with previous reports that women were more likely to have VI, both by prevalence3,8,10 and incidence,1,19 we observed the same sex difference in the long-term incidence of VI and blindness. This is likely because women have greater longevity than men, the latter having mortality as a competing risk that could have occurred before VI or blindness developed or was detected at the study follow-up visits.28,29
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Manuscript no. 230157.
The Medical Research Council Trial of the Assessment and Management of Older People in the Community was funded by the United Kingdom Medical Research Council, the Department of Health, and the Scottish Office. Collection of data on causes of visual impairment was funded by the Gift of Thomas Pocklington.