title: The Association of Health-Related Quality of Life with Severity of Visual Impairment among People Aged 40-64 Years: Findings from the 2006-2010 Behavioral Risk Factor Surveillance System.
abstract: To examine the association of health-related quality of life (HRQoL) with severity of visual impairment among people aged 40-64 years.
  
  
  
  We used cross-sectional data from the 2006-2010 Behavioral Risk Factor Surveillance System to examine six measures of HRQoL: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, or moderate/severe. We examined the association between visual impairment and HRQoL using logistic regression accounting for the survey's complex design.
  
  
  
  Overall, 23.0% of the participants reported a little difficult seeing, while 16.8% reported moderate/severe difficulty seeing. People aged 40-64 years with moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days, as well as greater life dissatisfaction, greater disability, and poorer health compared to people reporting no or a little visual impairment. After controlling for covariates (age, sex, marital status, race/ethnicity, education, income, state, year, health insurance, heart disease, stroke, heart attack, body mass index, leisure-time activity, smoking, and medical care costs), and compared to people with no visual impairment, those with moderate/severe visual impairment were more likely to have fair/poor health (odds ratio, OR, 2.01, 95% confidence interval, CI, 1.82-2.23), life dissatisfaction (OR 2.06, 95% CI 1.80-2.35), disability (OR 1.95, 95% CI 1.80-2.13), and frequent physically unhealthy days (OR 1.69, 95% CI 1.52-1.88), mentally unhealthy days (OR 1.84, 95% CI 1.66-2.05), and activity limitation days (OR 1.94, 95% CI 1.71-2.20; all p < 0.0001).
  
  
  
  Poor HRQoL was strongly associated with moderate/severe visual impairment among people aged 40-64 years.
authors.affiliation: a National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Crews
authors.affiliation: a National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Chiu-Fang
authors.initials: CF
authors.lastname: Chou
authors.affiliation: a National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Zack
authors.affiliation: b University of Alabama at Birmingham , Birmingham , AL , USA.
authors.forename: Xinzhi
authors.initials: X
authors.lastname: Zhang
authors.affiliation: a National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Kai McKeever
authors.initials: KM
authors.lastname: Bullard
authors.affiliation: c Lighthouse Guild , New York , NY , USA.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Morse
authors.affiliation: a National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Jinan B
authors.initials: JB
authors.lastname: Saaddine
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D016345:Medicare Part B; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D011788:Quality of Life; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology
keywords: Behavioral Risk Factor Surveillance System (BRFSS); health-related quality of life; middle age; visual impairment; working age