Is there a direct association between age-related eye diseases and mortality? The Rotterdam Study.
OBJECTIVE
To study mortality in subjects with age-related maculopathy (ARM), cataract, or open-angle glaucoma (OAG) in comparison with those without these disorders.


METHODS
Population-based prospective cohort study.


METHODS
Subjects (n = 6339) aged 55 years and older from the population-based Rotterdam Study for whom complete information on eye disease status was present.


METHODS
Vital status continuously monitored from 1990 until January 1, 2000.


METHODS
The diagnosis of ARM was made according to the International Classification System. Cataract, determined on biomicroscopy, was defined as any sign of nuclear or (sub)cortical cataract, or both, in at least one eye with a visual acuity of 20/40 or less. Aphakia and pseudophakia in at least one eye were classified as operated cataract. Definite OAG was defined as a glaucomatous optic neuropathy combined with a glaucomatous visual field defect. Diagnoses were assessed at baseline. Mortality hazard ratios were computed using Cox proportional hazard regression analysis, adjusted for appropriate confounders (age, gender, smoking status, body mass index, cholesterol level, atherosclerosis, hypertension, history of cardiovascular disease, and diabetes mellitus).


RESULTS
The adjusted mortality hazard ratio for subjects with AMD (n = 104) was 0.94 (95% confidence interval [CI], 0.52-1.68), with biomicroscopic cataract (n = 951) was 0.94 (95% CI, 0.74-1.21), with surgical cataract (n = 298) was 1.20 (95% CI, 0.86-1.68), and with definite OAG (n = 44) was 0.39 (95% CI, 0.10-1.55).


CONCLUSIONS
Both ARM and cataract are predictors of shorter survival because they have risk factors that also affect mortality. When adjusted for these factors, ARM, cataract, and OAG were themselves not significantly associated with mortality.
Borger
Petra H
PH
Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
van Leeuwen
Redmer
R
Hulsman
Caroline A A
CA
Wolfs
Roger C W
RC
van der Kuip
Deirdre A
DA
Hofman
Albert
A
de Jong
Paulus T V M
PT
D000368:Aged; D000375:Aging; D002386:Cataract / Q000175:diagnosis / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate