Modification of the Association between Visual Impairment and Mortality by Physical Activity: A Cohort Study among the Korean National Health Examinees

Kim, Kyoung Nam; Park, Sang Jun; Kim, Woo-Sung; Joo, Jungmin; Kim, Haebin; Kim, Kyae Hyung; Sohn, Ji Hoon; Kwon, Yong Jin

doi:10.3390/ijerph16224386

Cited by 5 publications

(14 citation statements)

References 35 publications

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“…After removing duplicate references, we screened the titles and abstracts of 2670 articles. Of these, we identified 76 unique studies in 92 articles for full-text review, during which 48 studies were excluded, leaving 28 studies 5 , 6 , 7 , 8 , 9 , 10 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 that met the inclusion criteria. Two of the studies each included two distinct cohorts; therefore, these 28 studies comprised 30 distinct cohorts (446 088 participants) from 12 countries.…”

Section: Resultsmentioning

confidence: 99%

“…The findings from six cohorts had been published since 2015. 5 , 6 , 7 , 8 , 9 , 10 The duration of follow-up among included studies ranged from 17 months to 210 months, with a mean of 103·3 (SD 46·4) months. Sample sizes ranged from 193 participants in Finland 21 to 359 984 participants in Korea.…”

Section: Resultsmentioning

confidence: 99%

“…Sample sizes ranged from 193 participants in Finland 21 to 359 984 participants in Korea. 6 24 cohorts contained an approximately equal number of male and female participants. However, the study by Pedula and colleagues 22 included female participants only, and five other cohorts comprised less than 40% male participants.…”

Section: Resultsmentioning

confidence: 99%

“…Measures of vision other than visual acuity were not commonly used. Several studies measured visual fields, 6 , 23 , 25 contrast sensitivity, 22 , 25 colour vision, 25 and stereopsis. 25 In this subset of studies, contrast sensitivity impairment, peripheral field loss, and stereoacuity impairment were all significantly associated with an increased hazard for mortality in adjusted models.…”

Section: Resultsmentioning

confidence: 99%

“…The most commonly used vision charts were logarithm of the minimum angle of resolution (n=6), 5 , 26 , 27 , 28 , 29 , 30 Snellen charts (n=5), 24 , 31 , 32 , 33 , 34 and Early Treatment Diabetic Retinopathy Study charts (n=5), 7 , 20 , 35 , 36 , 37 whereas two studies did not specify the instrument used. 6 , 23 There was also considerable heterogeneity in the methods used to define vision impairment. 15 (54%) studies used best-corrected visual acuity to define vision impairment, and 17 (61%) studies defined vision impairment based on visual acuity in the better-seeing eye.…”

Section: Resultsmentioning

confidence: 99%

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Association between vision impairment and mortality: a systematic review and meta-analysis

Ehrlich

Ramke

Macleod

et al. 2021

The Lancet Global Health

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Summary Background The number of individuals with vision impairment worldwide is increasing because of an ageing population. We aimed to systematically identify studies describing the association between vision impairment and mortality, and to assess the association between vision impairment and all-cause mortality. Methods For this systematic review and meta-analysis, we searched MEDLINE (Ovid), Embase, and Global Health database on Feb 1, 2020, for studies published in English between database inception and Feb 1, 2020. We included prospective and retrospective cohort studies that measured the association between vision impairment and all-cause mortality in people aged 40 years or older who were followed up for 1 year or more. In a protocol amendment, we also included randomised controlled trials that met the same criteria as for cohort studies, in which the association between visual impairment and mortality was independent of the study intervention. Studies that did not report age-adjusted mortality data, or that focused only on populations with specific health conditions were excluded. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We graded the overall certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations framework. We did a random-effects meta-analysis to calculate pooled maximally adjusted hazard ratios (HRs) for all-cause mortality for individuals with a visual acuity of <6/12 versus those with ≥6/12; <6/18 versus those with ≥6/18; <6/60 versus those with ≥6/18; and <6/60 versus those with ≥6/60. Findings Our searches identified 3845 articles, of which 28 studies, representing 30 cohorts (446 088 participants) from 12 countries, were included in the systematic review. The meta-analysis included 17 studies, representing 18 cohorts (47 998 participants). There was variability in the methods used to assess and report vision impairment. Pooled HRs for all-cause mortality were 1·29 (95% CI 1·20–1·39) for visual acuity <6/12 versus ≥6/12, with low heterogeneity between studies (n=15; τ 2 =0·01, I 2 =31·46%); 1·43 (1·22–1·68) for visual acuity <6/18 versus ≥6/18, with low heterogeneity between studies (n=2; τ 2 =0·0, I 2 =0·0%); 1·89 (1·45–2·47) for visual acuity <6/60 versus ≥6/18 (n=1); and 1·02 (0·79–1·32) for visual acuity <6/60 versus ≥6/60 (n=2; τ 2 =0·02, I 2 =25·04%). Three studies received an assessment of low risk of bias across all six domains, and six studies had a high risk of bias in one or more domains. Effect sizes were greater for studies that used best-corrected visual acuity compared with those that used presenting visual acuity as the vision assessment method (p=0·0055), but the effect sizes did no...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Association between vision impairment and mortality: a systematic review and meta-analysis

Ehrlich

Ramke

Macleod

et al. 2021

The Lancet Global Health

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Visual acuity and risk of overall, injury-related, and cardiovascular mortality: the Kangbuk Samsung Health Study

Han

Chang

Shin

et al. 2021

European Journal of Preventive Cardiology

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Aims The associations of visual impairment (VI) with cardio-metabolic risk factors have been reported but its association with cardiovascular mortality remains uncertain. Therefore, we evaluated the association of visual acuity (VA) with overall, injury-related, and cardiovascular mortality. Methods and results A cohort study was performed in 580 746 Korean adults (average age, 39.7 years) who were followed for a median of 8.1 years (maximum, 16 years). Presenting VA was measured by the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Visual acuity in the better vision eye was categorized as normal vision (≥0.8), lowered vision (0.5–0.8), mild visual impairment (VI) (0.3–0.5), or moderate to severe VI (<0.3). Vital status and cause of death were ascertained through linkage to national death records. During 4 632 892.2 person-years of follow-up, 6585 overall deaths, 974 cardiovascular deaths, and 1163 injury-related deaths were identified. After adjustment for possible confounders, the multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for overall mortality among participants with lowered vision, minimal VI, and moderate to severe VI were 1.21 (1.13–1.29), 1.26 (1.15–1.37), and 1.54 (1.40–1.68), respectively, compared with those with normal vision. The corresponding HRs (95% CIs) for injury-related mortality were 1.12 (0.96–1.32), 0.98 (0.76–1.26), and 1.36 (1.04–1.79), respectively, and the corresponding HRs (95% CIs) for cardiovascular mortality were 1.32 (1.12–1.57), 1.43 (1.15–1.77), and 2.41 (1.94–2.99). Conclusion In this large cohort of young and middle-aged individuals, VI was associated with increased risk of mortality especially due to cardiovascular disease.

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Association between Light Intensity Physical Activity and All-cause Mortality in Older Adults with Physical Disability

Lee¹,

Kang²

2022

Exerc Sci

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PURPOSE: This study aimed to investigate the association between light intensity physical activity (LPA) and all-cause mortality in older adults with physical disability.METHODS: Data from the 2008 Living Profiles of Older People Survey involving 14,367 Korean adults aged ≥60 years (13,417 without disabilities and 950 with disabilities) were used. Participants were divided into active and inactive groups based on weekly LPA and moderate-to-vigorous intensity physical activity (MVPA). Cox proportional hazards regression model was used to calculate hazard ratio (HR) and 95% confidence interval (CI), according to disability status and physical activity levels.RESULTS: During 3.3±0.4 years follow-up period, 1,024 deaths occurred from all causes. Among non-disabled people, the inactive group showed a significantly higher risk of all-cause mortality (HR=1.282, 95% CI=1.122–1.465, p<.001) than the active group (reference= 1) in LPA. Similarly, for MVPA, the risk of all-cause mortality was significantly higher in the inactive group (HR=1.522, 95% CI=1.230–1.882, p<.001) than in the active group (reference=1). However, among physically disabled people, the inactive group correspondingly showed a significantly higher risk of all-cause mortality (HR=2.735, 95% CI=1.761–4.246, p<.001) than the active group, while there was no significant difference between both groups in MVPA.CONCLUSIONS: The current findings suggest that promoting LPA may play an important role in preventing premature death from allcause mortality in older adults with physical disability.

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Modification of the Association between Visual Impairment and Mortality by Physical Activity: A Cohort Study among the Korean National Health Examinees

Cited by 5 publications

References 35 publications

Association between vision impairment and mortality: a systematic review and meta-analysis

Association between vision impairment and mortality: a systematic review and meta-analysis

Visual acuity and risk of overall, injury-related, and cardiovascular mortality: the Kangbuk Samsung Health Study

Association between Light Intensity Physical Activity and All-cause Mortality in Older Adults with Physical Disability

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