title: Education, socio-economic status and age-related macular degeneration in Asians: the Singapore Malay Eye Study.
abstract: OBJECTIVE
  Low socio-economic status is increasingly being identified as a risk marker for chronic diseases, but few studies have investigated the link between socio-economic factors and age-related macular degeneration (AMD). The present study aimed to assess the association between socio-economic status and the prevalence of AMD.
  
  
  METHODS
  A population-based cross-sectional study of 3280 (78.7% response rate) Malay adults aged 40-80 years residing in 15 south-western districts of Singapore. AMD was graded from retinal photographs at a central reading centre using the modified Wisconsin AMD scale. Early and late AMD signs were graded from retinal photographs following the Wisconsin grading system. Socio-economic status including education, housing type and income were determined from a detailed interview.
  
  
  RESULTS
  Of the participants, 3265 had photographs of sufficient quality for grading of AMD. Early AMD was present in 168 (5.1%) and late AMD in 21 (0.6%). After adjusting for age, gender, smoking, hypertension, diabetes and body mass index, participants with lower educational levels were significantly more likely to have early AMD (multivariate OR 2.2, 95% CI 1.2 to 4.0). This association was stronger in persons who had never smoked (multivariate OR 3.6, 95% confidence CI 1.4 to 9.4). However, no association with housing type or income was seen.
  
  
  CONCLUSIONS
  Low educational level is associated with a higher prevalence of early AMD signs in our Asian population, independent of age, cardiovascular risk factors and cigarette smoking.
authors.affiliation: Singapore Eye Research Institute, Singapore.
authors.forename: P
authors.initials: P
authors.lastname: Cackett
authors.forename: W T
authors.initials: WT
authors.lastname: Tay
authors.forename: T
authors.initials: T
authors.lastname: Aung
authors.forename: J J
authors.initials: JJ
authors.lastname: Wang
authors.forename: A
authors.initials: A
authors.lastname: Shankar
authors.forename: S M
authors.initials: SM
authors.lastname: Saw
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: T Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012307:Risk Factors; D017678:Sex Distribution; D012846:Singapore / Q000453:epidemiology; D012923:Social Class