title: The association between cataract and mortality among older adults.
abstract: BACKGROUND
  Previous research has suggested that persons with cataract have an increased risk of death.
  
  
  OBJECTIVE
  To compare the mortality experience of patients with cataract who elect surgery, patients with cataract who do not elect surgery, and patients without cataract independent of potentially confounding risk factors.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Ophthalmology and optometry clinics affiliated with the Callahan Eye Foundation Hospital in Birmingham, Alabama.
  
  
  METHODS
  384 persons with and without cataract.
  
  
  METHODS
  Mortality.
  
  
  RESULTS
  Of the 384 study subjects, 286 had cataract, of whom 200 elected to have cataract surgery. Patients with cataract who did and did not elect surgery had significantly higher mortality compared to those without cataract (crude mortality rate ratio (MRR) 3.9 (95% confidence interval (CI) 1.5-9.8) and 7.3 (95% CI 2.8-19.1), respectively). After adjustment for age, gender, race, education, chronic medical conditions, smoking, drinking, depression, and cognitive status, the no-surgery cataract group had an elevated mortality rate (MRR 3.2 (95% 1.2-9.0)), compared to the no-cataract group, with a borderline elevation in MR for the surgery group (MRR 2.0 (95% 0.8-5.9). Limiting the study population to non-diabetics or those without concurrent eye conditions (glaucoma, maculopathy, retinopathy) did not materially influence the adjusted MRRs although the precision of the estimates was reduced.
  
  
  CONCLUSIONS
  The results suggest that older persons with cataract, in particular those who decline surgery, have an increased risk of death, supporting the hypothesis that age-related cataract reflects systemic as well as localized ocular disease.
authors.affiliation: Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, AL, USA. gerald.mcgwin@ccc.uab.edu
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owsley
authors.forename: Scott
authors.initials: S
authors.lastname: Gauthreaux
mesh_terms: D000368:Aged; D000407:Alabama / Q000453:epidemiology; D002386:Cataract / Q000401:mortality* / Q000628:therapy; D002387:Cataract Extraction / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D015996:Survival Rate