Vision Impairment and Health Outcomes among Older Mexican Americans: Findings from the Hispanic Established Population for the Epidemiologic Study of the Elderly

Background: Vision impairment (VI) is one of the most common conditions in older adults. It is associated with negative health outcomes leading to disability and decreased quality of life. Objectives: To examine 1) predictor factors of VI; 2) the effect of VI on physical and cognitive function, frailty, disability, and falls; and 3) VI as predictor of eye and health care utilization among older Mexican Americans over time. Design: Longitudinal study. Participants: Mexican Americans aged 70 years and older (N=1,979) from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1998-2016). Measures: Included self-reported VI as the independent variable; physical and cognitive function, modified frailty phenotype, disability, falls, and health care utilization as outcome variables; and socio-demographics, social isolation, smoking status, body mass index, comorbidities, depressive symptoms, and hearing impairment as covariates. Analysis: Generalized estimating equation models were performed to estimate the odds ratio of health outcomes and health care utilization. Results: Percent of VI ranged from 3.7% to 4.3% for near vision impairment (NVI), 12.9% to 27.8% for distant vision impairment (DVI), and 13.7% to 27.6% for VI (NVI or DVI). Predictors of NVI, DVI, and VI were time (years), lower Mini Mental State Exam score, depressive symptoms, and hearing impairment. Spanish interview was a predictor of NVI only. Over time, participants with cognitive impairment and frailty had greater odds of reporting DVI and VI (NVI or DVI) than those without VI; those with limitations in instrumental activities of daily living had greater odds of reporting NVI, DVI, and VI (NVI or DVI) than those without VI; those with limitations in activities of daily living had greater odds of reporting VI than those without VI; and those who reported falls had greater odds of reporting NVI and VI (NVI or DVI) than those without VI. Those with VI had greater odds of having medical doctor visits and been hospitalized than those without VI. Conclusions: VI among older Mexican Americans was high and is a strong independent predictor of cognitive impairment, frailty, disability, and falls. These findings suggest that current vision health disparities exist among older Mexican Americans.