Abstract
Objectives
To assess the association between far vision impairment (objective and subjective) and perceived stress among older adults from six low- and middle-income countries (LMICs, i.e., China, Ghana, India, Mexico, Russia, and South Africa).
Methods
Data from the WHO Study on global AGEing and adult health were analyzed. Objective visual acuity was measured using the tumbling E LogMAR chart and was used as a four-category variable (no, mild, moderate, and severe visual impairment). Subjective visual impairment referred to difficulty in seeing and recognizing an object or a person across the road. Using two questions from the Perceived Stress Scale, a perceived stress variable was computed, and ranged from 0 (lowest stress) to 100 (highest stress). Multivariable linear regression with perceived stress as the outcome was conducted.
Results
Data on 14,585 adults aged ≥65 years [mean (SD) age 72.6 (11.5) years; 55.0% females] were analyzed. Only severe objective visual impairment (versus no visual impairment) was significantly associated with higher levels of stress (b = 6.91; 95% CI = 0.94–12.89). In terms of subjective visual impairment, compared with no visual impairment, mild (b = 2.67; 95% CI = 0.56–4.78), moderate (b = 8.18; 95% CI = 5.84–10.52), and severe (b = 11.86; 95% CI = 9.11–14.61) visual impairment were associated with significantly higher levels of perceived stress.
Conclusions
This large study showed that far vision impairment was associated with increased perceived stress levels among older adults in LMICs. Increased availability of eye care services may reduce stress among those with visual impairment in LMICs, while more research is needed to better characterize the directionality of the far vision impairment–perceived stress relationship.
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Data availability
The datasets generated during and/or analyzed during the current study are available in the Global Ageing and Adult Health Survey repository, available at http://www.who.int/healthinfo/sage/en.
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Acknowledgements
This paper uses data from WHO’s Study on global AGEing and adult health (SAGE). SAGE is supported by the US National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01, and through research grants R01-AG034479 and R21-AG034263.
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LJ contributed to the design of the study, managed the literature searches, wrote the first draft of the manuscript, and corrected the manuscript. KK, LS, GFL-S, SP, HO, JIS, ASA, and JMH contributed to the design of the study and corrected the manuscript. AK contributed to the design of the study, performed the statistical analyses, and corrected the manuscript. All authors contributed to and have approved the final manuscript.
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Jacob, L., Kostev, K., Smith, L. et al. Association of objective and subjective far vision impairment with perceived stress among older adults in six low- and middle-income countries. Eye 36, 1274–1280 (2022). https://doi.org/10.1038/s41433-021-01634-7
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DOI: https://doi.org/10.1038/s41433-021-01634-7
