Longitudinal prevalence of major eye diseases.
OBJECTIVE
To describe the prevalence across time of 3 chronic eye diseases among a representative cohort of elderly subjects.


METHODS
Longitudinal observation of Medicare claims. Population A random sample of Medicare beneficiaries 65 years and older, nationally representative at baseline.


METHODS
Diagnosis of diabetic retinopathy, glaucoma, and age-related macular degeneration.


METHODS
Beneficiaries were followed from 1991 to 1999 unless mortality or enrollment in a health maintenance organization for 6 or more months in a year intervened. Claims data were analyzed for the presence of codes from the International Classification of Diseases, Ninth Revision, Clinical Modification, indicating 1 of the 3 conditions. Transitions between severity stages were also evaluated.


RESULTS
Of 20 325 beneficiaries in 1991, 10 476 were available for analysis in 1999. The prevalence of diabetes mellitus increased from 14.5% in 1991 to 25.6% by 1999, with diabetic retinopathy among persons with diabetes mellitus increasing from 6.9% to 17.4%. Primary open-angle glaucoma increased from 4.6% to 13.8%. The percentage of glaucoma suspects increased from 1.5% to 6.5%, as did the percentage of narrow-angle glaucoma (0.7%-2.7%). The prevalence of age-related macular degeneration increased from 5.0% to 27.1%. Overall, the proportion of subjects with at least 1 of these 3 diseases increased from 13.4% to 45.4%.


CONCLUSIONS
The clinical diagnosis of major chronic eye diseases associated with aging increased dramatically in a longitudinal sample. At the end of 9 years, nearly half of the surviving Medicare beneficiaries had at least 1 of these diseases.
Lee
Paul P
PP
Department of Ophthalmology, School of Medicine, Department of Economics, and Center for Health Policy, Law, and Management, Duke University, Durham, NC 27708, USA.
Feldman
Zachary W
ZW
Ostermann
Jan
J
Brown
Derek S
DS
Sloan
Frank A
FA
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008268:Macular Degeneration / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D006278:Medicare; D015995:Prevalence; D014481:United States / Q000453:epidemiology