Temporal Trends over a Decade in Serious Vision Impairment in a Large, Nationally Representative Population-based Sample of Older Americans: Gender, Cohort and Racial/Ethic Differences

Purpose : The objectives of this study are:1)To identify temporal trends in the age-sex-race/ethnicity adjusted prevalence of vision impairment among Americans aged 65+ from 2008-2017; To determine if these temporal trends in vision impairment differ by 2)gender and age cohort, and 3)race/ethnicity, and; 4)To investigate if improvements in cohort educational attainment partially attenuate these trends. Methods : Secondary analysis of 10 years of annual nationally-representative data from the American Community Survey with 5.4 million community-dwelling and institutionalized older adults aged 65+. The question on vision impairment was "Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?". Results : The prevalence of serious vision impairment in the US population aged 65+ declined from 8.3% to 6.6% between 2008 and 2017. There would have been an additional 848,000 older Americans with serious vision impairment in 2017 if rates had remained at the 2008 level. After age, sex and race/ethnicity were controlled, women had a 2.1% per year decline in the odds of vision impairment (OR = 0.979; CI = 0.977, 0.980), which represents a 21% decline over the decade, and men had a 9% decline over the decade (OR = 0.991; CI = 0.989, 0.993). Adjusting for education attenuated the decade decline among women, reducing it to 13%, and completely attenuated the decline among men. Most of the decline was among those aged 75+. Racial/ethnic disparities narrowed over the decade. Conclusion : Between 2008 and 2017, the prevalence of serious vision impairment among older Americans declined significantly, with steeper declines among African Americans and Hispanic Americans than among non-Hispanic White Americans.