The Current Status of Visual Disability in the Elderly Population of Taiwan

Purpose This study was conducted to explore the prevalence and the associated factors of visual impairment and blindness among the elderly Taiwanese population.Methods A nationwide population-based visual health care screening program of elderly people aged 65 years or older was conducted between 1 July 2002 and 31 December 2002 in Taiwan. Based on the same standardized protocol used by the Bureau of Health Promotion, Department of Health, and a stratified random sampling design, 3160 out of 5000 elderly subjects were selected by a two-stage visual care screening method. The overall response rate was 63.2%.Results The mean age of the elderly participants was 72.4 ± 5.1 years. The overall prevalence of glaucoma, corneal diseases, trauma, cataracts, myopic or diabetic retinopathy, and age-related macular degeneration among the elderly population was 2.1%, 6.3%, 0.9%, 60.2%, 7.5%, and 2.9%, respectively. The overall prevalence of visual disability (visual acuity of the better eye <0.5) was 17.7%, including 17.1% with visual impairment and 0.6% with blindness. Based on logistic regression, the significant independent factors of visual disability (visual impairment plus blindness) were sex (male vs. female, odds ratio (OR) = 0.62, 95% confidence interval (CI), 0.51–0.76), age (70–74 years vs. 65–69 years, OR = 1.60, 95% CI, 1.24–2.06; 75–79 years vs. 65–69 years, OR = 2.52, 95% CI, 1.92–3.32, 80yrs vs. 65–69yrs, OR = 4.86, 95% CI, 3.52–6.70), corneal diseases (OR = 2.26, 95% CI, 1.61–3.16), myopic or diabetic retinopathy (OR = 1.69, 95% CI, 1.20–2.39), age-related macular degeneration (OR = 4.96, 95% CI, 3.16–7.78), and cataract (OR = 3.40, 95% CI, 2.67–4.33).Conclusions The geographic difference in the prevalence of vision-related eye disease, visual impairment, and blindness point to the importance of taking actions that suit local circumstances. Our results also revealed that visual impairment and blindness are important visual health problems in the elderly Taiwanese population. Age-related macular degeneration, cataracts, corneal diseases, myopic or diabetic retinopathy, female sex, and aging were the leading causes of visual disability. Further organized preventive strategies for eye care are recommended in this population. Jpn J Ophthalmol 2005;49: 166–172 © Japanese Ophthalmological Society 2005