Longitudinal Associations Between Vision Impairment and the Incidence of Neuropsychiatric, Musculoskeletal, and Cardiometabolic Chronic Diseases.

Abstract Purpose To compare the incidence and hazard of neuropsychiatric, musculoskeletal, and cardiometabolic conditions among adults with and without vision impairment (VI). Design Retrospective cohort study. Methods: Setting Enrollees in a large private health insurance provider in the U.S. Study Population 24,657 adults age ≥18 years with VI and age- and sex-matched controls. Exposure VI, based on low vision and blindness ICD-9-CM and ICD-10-CM diagnosis codes. Main Outcome Measures : Physician-diagnosed incident neuropsychiatric, musculoskeletal, and cardiometabolic diseases were identified using ICD codes. Separate Cox proportional hazards regression models were used to assess the association of VI with incidence of 30 chronic conditions, adjusting for Elixhauser Comorbidity Index. Analyses were stratified by age 18-64 years and >65 years. Results In individuals with VI age 18-64 years (n=7,478), the adjusted hazard of neuropsychiatric (HR= 2.1; 95% CI: 1.9, 2.4), musculoskeletal (HR= 1.8; 95% CI: 1.7, 2.0), and cardiometabolic (HR= 1.8; 95% CI: 1.7, 2.0) diseases was significantly greater than in matched controls (mean 5.5 years follow-up). Similar associations were seen between patients with VI age ≥65 years (n=17,179) for neuropsychiatric (HR= 2.4; 95% CI: 2.1, 2.7), musculoskeletal (HR= 1.8; 95% CI: 1.6, 1.9), and cardiometabolic (HR= 1.7; 95% CI: 1.4, 2.0). VI was associated with a higher hazard of each of the 30 conditions we assessed, with similar results in both age cohorts. Conclusion Across the lifespan, adults with VI had an approximately two-fold greater adjusted hazard for common neuropsychiatric, musculoskeletal, and cardiometabolic disorders compared to matched controls without VI.