title: Area deprivation and age related macular degeneration in the EPIC-Norfolk Eye Study.
abstract: OBJECTIVE
  To investigate the relationship between area deprivation, individual socio-economic status (SES) and age related macular degeneration (AMD).
  
  
  METHODS
  Cross sectional study nested within a longitudinal cohort study.
  
  
  METHODS
  Data were collected in the EPIC-Norfolk Eye Study by trained nurses, using standardized protocols and lifestyle questionnaires. The English Index of multiple deprivation 2010 (IMD) was derived from participants' postcodes. AMD was identified from standardized grading of fundus photographs. Logistic regression was used to examine associations between IMD, SES and AMD.
  
  
  RESULTS
  5344 pairs (62.0% of total 8623) of fundus photographs were of sufficient quality for grading of AMD. Of 5182 participants with complete data, AMD was identified in 653 participants (12.60%, 95%CI = 11.7-13.5%). Multivariable logistic regression showed that people living in the most affluent 5% of areas had nearly half the odds of AMD compared to those living in comparatively more deprived areas (OR = 0.56, 95% CI = 0.36-0.89, P = 0.02), after adjusting for age, sex, education, social class and smoking.
  
  
  CONCLUSIONS
  The authors found that living in the most affluent areas exerted a protective effect on AMD, independently of education and social class. Further investigation into underlying mechanisms will inform potential interventions to reduce health inequalities relating to AMD.
authors: Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK; NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK. Electronic address: jlyy2@medschl.cam.ac.uk.
authors: Jennifer L Y
authors: JL
authors: Yip
authors: Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK; NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.
authors: Anthony P
authors: AP
authors: Khawaja
authors: NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.
authors: Michelle P Y
authors: MP
authors: Chan
authors: Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.
authors: David C
authors: DC
authors: Broadway
authors: NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.
authors: Tunde
authors: T
authors: Peto
authors: Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
authors: Robert
authors: R
authors: Luben
authors: Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
authors: Shabina
authors: S
authors: Hayat
authors: Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
authors: Amit
authors: A
authors: Bhaniani
authors: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors: Nick
authors: N
authors: Wareham
authors: NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.
authors: Paul J
authors: PJ
authors: Foster
authors: Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
authors: Kay-Tee
authors: KT
authors: Khaw
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008268:Macular Degeneration / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011204:Poverty Areas; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: Area deprivation; Inequalities; Macular degeneration