Prevalence and predictors of vision impairment among older adults in India: evidence from LASI, 2017-18.

backgroundOlder adults experience a natural decline in health, physical and cognitive functionality, and vision impairment (VI) is one among them and has become an increasing health concern worldwide. The present study assessed the association of chronic morbidities such as diabetes, hypertension, stroke, heart diseases and various socioeconomic factors with VI among older Indian adults.

methodsData for this study were derived from the nationally-representative Longitudinal Ageing Study in India (LASI), wave-1 (2017-18). VI was assessed using the cut-off of visual acuity worse than 20/80, and additional analysis was carried out using the definition of VI with a cut-off of visual acuity worse than 20/63. Descriptive statistics along with cross-tabulation were presented in the study. Proportion test was used to evaluate the significance level for sex differentials in VI among older adults. Additionally, multivariable logistic regression analysis was conducted to explore the factors associated with VI among older adults.

resultsAbout 33.8% of males and 40% of females suffered from VI in India (visual acuity worse than 20/80). Meghalaya (59.5%) had the highest prevalence for VI among older males followed by Arunachal Pradesh (58.4%) and Tripura (45.2%). Additionally, Arunachal Pradesh (77.4%) had the highest prevalence for VI among females followed by Meghalaya (68.8%) and Delhi (56.1%). Among the health factors, stroke [AOR: 1.20; CI: 1.03-1.53] and hypertension [AOR: 1.12; CI: 1.01-1.22] were the significant risk factors for VI among older adults. Additionally, being oldest old [AOR: 1.58; CI: 1.32-1.89] and divorced/separated/deserted/others [AOR: 1.42; CI: 1.08-1.87] were significantly associated with VI. Moreover, older adults with higher educational status [AOR: 0.42; CI: 0.34, 0.52], currently working [AOR: 0.77; CI: 0.67, 0.88], from urban areas [AOR: 0.86; CI: 0.76-0.98] and from western region [AOR: 0.55; CI: 0.48-0.64] had lower odds of VI in this study.

conclusionThis study identified higher rates of VI among those who are diagnosed with hypertension or stroke, currently unmarried, socioeconomically poorer, less educated and urban resident older people that can inform strategies to engage high risk groups. The findings also suggest that specific interventions that promote active aging are required for those who are socioeconomically disadvantaged as well as visually impaired.