Risk of type 2 diabetes mellitus among adults aging with vision impairment: The role of the neighborhood environment |
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| Affiliation: | 1. Institute for Social Research, University of Michigan, Ann Arbor, MI, USA;2. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA;3. University of Michigan Center for Disability Health and Wellness, Ann Arbor, MI, USA;4. Department of Sociology, Indiana University School of Liberal Arts, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA;5. Department of Ophthalmology & Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA;6. Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA;7. Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA;8. Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA;1. Faculty of Physical Education, Shenzhen University, Shenzhen, China;2. Cardiac Rehabilitation Center, Fuwai Hospital, CAMS&PUMC, Beijing, China;3. Children''s Healthcare & Mental Health Center, Shenzhen Children''s Hospital, Shenzhen, China;1. Division of Fire Safety Engineering, Lund University, Box 118, SE-221 00, Lund, Sweden;2. Department of Health Science, Lund University, Box 157, SE-221 00, Lund, Sweden;1. Health Policy Research Center-Mongan Institute, Massachusetts General Hospital, USA;2. Department of Medicine, Harvard Medical School, USA;3. Boston University School of Public Health, USA;4. Center for Bioethics and Humanities, Department of Medicine, USA;5. University of Colorado School of Medicine, Center for Survey Research, University of Massachusetts-Boston, USA;1. Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Parkville, VIC 3010, Australia;2. School of Business, University of New South Wales, Northcott Dr, Canberra, ACT 2610, Australia;1. California Retina Consultants and Research Foundation, Santa Barbara, California;2. University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii |
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| Abstract: | ![]()
BackgroundVision impairment (VI) affects approximately 1 in 28 Americans over the age of 40 and the prevalence increases sharply with age. However, experiencing vision loss with aging can be very different from aging with VI acquired earlier in life. People aging with VI may be at increased risk for diabetes due to environmental barriers in accessing health care, healthy food, and recreational resources that can facilitate positive health behaviors.ObjectiveThis study examined the relationship between neighborhood characteristics and incident type 2 diabetes mellitus (T2DM) among a cohort of 22,719 adults aging with VI.MethodsData are from Optum® Clinformatics® DataMart, a private administrative claims database (2008–2017). Individuals 18 years of age and older at the time of their initial VI diagnosis were eligible for analysis. VI was determined using vision impairment, low vision, and blindness codes (ICD-9-CM, ICD-10-CM). Covariates included age, sex, and comorbidities. Cox models estimated adjusted hazard ratios (HRs) for incident T2DM. Stratified models examined differences in those aging with (age 18–64) and aging into (age 65+) vision impairment.ResultsResidence in neighborhoods with greater intersection density (HR = 1.26) and high-speed roads (HR = 1.22) were associated with increased risk of T2DM among older adults with VI. Living in neighborhoods with broadband internet access (HR = 0.67), optical stores (HR = 0.62), supermarkets (HR = 0.78), and gyms/fitness centers (HR = 0.63) was associated with reduced risk of T2DM for both younger and older adults with VI.ConclusionsFindings emphasize the importance of neighborhood context for mitigating the adverse consequences of vision loss for health. |
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| Keywords: | Vision impairment Diabetes Neighborhood environment Aging |
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