Assessing Age-Related Vision Impairment

More than half of the 14 million people in the U.S. living with vision impairment (VI) or blindness are age 65 and older. Racial and ethnic minorities are disproportionately affected, and the number of people suffering from VI is anticipated to double by 2050 as our population ages. Social determinants of health (SDoH) like healthcare access and economic stability play a large role in shaping who is impacted.

Older adults with VI are thought to be at elevated risk for many adverse outcomes, including dementia, admission to a long-term care facility, and even death.

Kellogg clinician-scientist Joshua Ehrlich, M.D., M.P.H., is painting a more precise picture of the impact of age-associated vision loss. A leader in vision-related population and health services research in the U.S. and around the world, Dr. Ehrlich has been awarded a National Institutes of Health (NIH) R01 grant to analyze newlycollected data on the vision health of U.S. seniors— a data set he helped develop.

Since 2011, the NIH has funded the National Health and Aging Trends Study (NHATS), which, through annual in-person surveys conducted in respondents’ homes, gathers health data annually on more than 7,000 adults 65 years and older. In 2021, NHATS added a battery of objective measures of visual function to gauge respondents’ distance and near vision and contrast sensitivity.

Dr. Ehrlich played a pivotal role in developing, testing and validating those measures. He can now begin analyzing the two years of available data, adding an additional year’s data annually throughout the grant’s five-year duration. He will be assisted by Kellogg investigators Lindsey De Lott, M.D., M.S., and Angela Elam, M.D., M.P.H., and by colleagues at the U-M Institute for Social Research, where he also has a faculty appointment.

The project has three aims. First, to describe the state of vision impairment in older adults. Second, to analyze the impact various SDoH have on VI late in life. And finally, to study the impact over time of VI and blindness on the development of dementia, placement in a long-term care facility, and mortality—all factors captured in NHATS.

With this project, Dr. Ehrlich’s team is responding to key strategic research goals included in the National Eye Institute’s five-year strategic plan, as well as international research priorities articulated by the Lancet Global Health Commission on Global Eye Health, a worldwide consortium of experts of which Dr. Ehrlich is part.

“Until now, we haven’t had nationally representative longitudinal data in the U.S. on the connection between VI, SDoH and critical late-life outcomes,” he explains. “These studies are the first step in closing that knowledge gap.”

Header image caption: Joshua Ehrlich, M.D., M.P.H.