Abstract
PURPOSE: Determine the prevalence and vision-related quality of life (VRQoL) effects of single and multiple visual function impairments (VFIs) in multi-ethnic older Asians. METHODS: A total of 2380 participants from a population-based cohort study were included. Visual function comprised presenting visual acuity (VA), contrast sensitivity (CS), depth perception (DP), and color vision (CV). Rasch-transformed VRQoL was obtained using the Brief Impact of Visual Impairment questionnaire. Multiple linear regression explored the independent (mutually adjusting for each VFI) impact of bilateral single (VAI, CSI, CVI and DPI) and multiple (i.e., the co-occurrence of any two, three, or four bilateral VFI) VFIs on VRQoL. Dominance analysis estimated the relative contribution for each of the single VFI on VRQoL. RESULTS: The prevalence of bilateral VAI, CSI, CVI, or DPI alone was 15.3%, 20.7%, 8.1%, and 23.5%, respectively, whereas for concurrent two, three and four bilateral VFIs was 11%, 4.1% and 1.6%, respectively. Participants with single bilateral VFI (except CVI) experienced poorer overall VRQoL (β -0.25 to -0.34; all p < 0.05) compared to those without. CSI had the largest contribution (25%), to the decline in overall VRQoL. As the number of concurrent bilateral VFIs increased, VRQoL progressively worsened (% decrements -12.26% to -25.61%; all P < 0.001) compared to no VFI. CONCLUSIONS: Bilateral single and multiple VFIs are prevalent in older Asians. CSI had the largest contribution to VRQoL decrements. There was a systematic worsening in VRQoL scores with an increase in concurrent bilateral VFI. Comprehensive visual function testing may be warranted to prevent the debilitating consequences of VFIs on healthy aging.