Association of nonrefractive visual impairment with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 1999 to 2008
Abstract Objective To investigate and describe the impact of nonrefractive visual impairment (NVI) and its severity on all-cause and cause-specific mortality, along with the latest estimations. Methods Cox proportional hazards regression models with multiple covariate adjustments and Fine-Gray compe...
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2025-03-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22249-7 |
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| author | Siyu Gui Xinchen Wang Qianqian Wang Lan Zhong Jianchao Qiao Yueyang Xu Yiran Li Zhihao Huang Chengyang Hu Fangbiao Tao Xiaodong Sun Heting Liu Jie Gao |
| author_facet | Siyu Gui Xinchen Wang Qianqian Wang Lan Zhong Jianchao Qiao Yueyang Xu Yiran Li Zhihao Huang Chengyang Hu Fangbiao Tao Xiaodong Sun Heting Liu Jie Gao |
| author_sort | Siyu Gui |
| collection | DOAJ |
| description | Abstract Objective To investigate and describe the impact of nonrefractive visual impairment (NVI) and its severity on all-cause and cause-specific mortality, along with the latest estimations. Methods Cox proportional hazards regression models with multiple covariate adjustments and Fine-Gray competing risk regression models assessed the risk of all-cause and specific-cause mortality. Propensity score matching (PSM) was employed to achieve covariate balance. Results Among 7 961 participants (representing 171 383 125 non-institutionalized US individuals), baseline NVI was present in 350 participants (4.40%), with 313 (3.93%) having mild NVI and 37 (0.47%) having severe NVI. Both any NVI and Severe NVI were associated with increased all-cause and diabetes mellitus (DM)-related mortality. After PSM, the results remained consistent (for all-cause mortality: HR, 1.34; 95% CI, 1.05–1.70; for DM-related mortality: HR, 3.54; 95% CI, 1.15–10.97). Severity analysis demonstrated a significant trend between increasing NVI severity and elevated risks of all-cause and DM-specific mortality. Conclusion Our findings confirm that NVI and its severity are independent risk factors for all-cause and DM-specific mortality among the US population. This highlights the importance of regular visual acuity examinations, particularly for NVI screening, especially in individuals with diabetes. |
| format | Article |
| id | doaj-art-7f0b39fb923a4ac99ee6d718f028230b |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj-art-7f0b39fb923a4ac99ee6d718f028230b2025-08-20T03:40:44ZengBMCBMC Public Health1471-24582025-03-0125111210.1186/s12889-025-22249-7Association of nonrefractive visual impairment with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 1999 to 2008Siyu Gui0Xinchen Wang1Qianqian Wang2Lan Zhong3Jianchao Qiao4Yueyang Xu5Yiran Li6Zhihao Huang7Chengyang Hu8Fangbiao Tao9Xiaodong Sun10Heting Liu11Jie Gao12Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, Mingguang City People’s HospitalDepartment of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical UniversityDepartment of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical UniversityDepartment of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical UniversityDepartment of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical UniversityDepartment of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical UniversityDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityAbstract Objective To investigate and describe the impact of nonrefractive visual impairment (NVI) and its severity on all-cause and cause-specific mortality, along with the latest estimations. Methods Cox proportional hazards regression models with multiple covariate adjustments and Fine-Gray competing risk regression models assessed the risk of all-cause and specific-cause mortality. Propensity score matching (PSM) was employed to achieve covariate balance. Results Among 7 961 participants (representing 171 383 125 non-institutionalized US individuals), baseline NVI was present in 350 participants (4.40%), with 313 (3.93%) having mild NVI and 37 (0.47%) having severe NVI. Both any NVI and Severe NVI were associated with increased all-cause and diabetes mellitus (DM)-related mortality. After PSM, the results remained consistent (for all-cause mortality: HR, 1.34; 95% CI, 1.05–1.70; for DM-related mortality: HR, 3.54; 95% CI, 1.15–10.97). Severity analysis demonstrated a significant trend between increasing NVI severity and elevated risks of all-cause and DM-specific mortality. Conclusion Our findings confirm that NVI and its severity are independent risk factors for all-cause and DM-specific mortality among the US population. This highlights the importance of regular visual acuity examinations, particularly for NVI screening, especially in individuals with diabetes.https://doi.org/10.1186/s12889-025-22249-7Visual impairmentAll-Cause mortalitySpecific-Cause mortality |
| spellingShingle | Siyu Gui Xinchen Wang Qianqian Wang Lan Zhong Jianchao Qiao Yueyang Xu Yiran Li Zhihao Huang Chengyang Hu Fangbiao Tao Xiaodong Sun Heting Liu Jie Gao Association of nonrefractive visual impairment with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 1999 to 2008 BMC Public Health Visual impairment All-Cause mortality Specific-Cause mortality |
| title | Association of nonrefractive visual impairment with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 1999 to 2008 |
| title_full | Association of nonrefractive visual impairment with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 1999 to 2008 |
| title_fullStr | Association of nonrefractive visual impairment with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 1999 to 2008 |
| title_full_unstemmed | Association of nonrefractive visual impairment with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 1999 to 2008 |
| title_short | Association of nonrefractive visual impairment with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 1999 to 2008 |
| title_sort | association of nonrefractive visual impairment with risk of all cause and specific cause mortality in the national health and nutrition examination survey 1999 to 2008 |
| topic | Visual impairment All-Cause mortality Specific-Cause mortality |
| url | https://doi.org/10.1186/s12889-025-22249-7 |
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