Visual function in working-age adults: early life influences and associations with health and social outcomes.
OBJECTIVE
To investigate how visual function in mid-adult life is associated with health and social outcomes and, using life-course epidemiology, whether it is influenced by early life biological and social factors.


METHODS
Population-based cohort study.


METHODS
Nine thousand three hundred thirty members of the 1958 British birth cohort at age 44 or 45 years.


METHODS
Distance, near, and stereo vision were assessed as part of a broader biomedical examination. Logistic, multinomial, and proportional odds ordinal logistic regression were used, as appropriate, to assess the association between these vision functions and both key early life influences and health and social outcomes in mid-adult life.


METHODS
Distance, near, and stereo acuities and health and social outcomes.


RESULTS
In mid-adult life, vision function (across the full spectrum of both type and level of function) is associated with unemployment resulting from permanent sickness, lower socioeconomic status, and poorer general health (for example, for blindness; odds ratios were 2.5, 2.6, and 1.2, respectively). Also, impaired visual functions in mid-adult life are associated with a low birthweight, being small for gestational age, maternal smoking in pregnancy, and markers of socioeconomic deprivation in childhood (for example, for impaired distance acuity; odds ratios were 1.4, 1.3, 1.02, and 1.1, respectively).


CONCLUSIONS
Although relatively uncommon in working-age adults, impaired vision can have important adverse consequences, which highlights the value of investigating visual function in the broader context of health and social functioning. In addition, visual function in adult life may be influenced directly by key prenatal and childhood biological and social determinants of general health. Thus, application of life-course epidemiology to complex chronic ophthalmic diseases of adult life such as glaucoma or macular degeneration is likely to prove valuable in elucidating whether and how biological, social, and lifestyle factors contribute to the cause.
Rahi
Jugnoo S
JS
MRC Centre of Epidemiology for Child Health, Institute of Child Health, University College London, London, UK. j.rahi@ich.ucl.ac.uk
Cumberland
Phillippa M
PM
Peckham
Catherine S
CS
D000203:Activities of Daily Living; D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D012923:Social Class; D012938:Social Perception; D014478:Unemployment; D014786:Vision Disorders / Q000503:physiopathology*; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology*; D014937:Work