Gender-specific changes in vision-related quality of life over time - results from the population-based Gutenberg Health Study.

purposeTo investigate potential gender- and age-specific changes over time in vision-related quality of life (VRQoL) on a population-based level. Further, factors associated with changes in VRQoL will be explored.

methodsThe Gutenberg Health Study is a population-based, prospective, observational, single-center cohort study in Germany. VRQoL was quantified at baseline and 5-year follow-up using the visual function scale (VFS) and socio-emotional scale (SES-VRQoL). VFS and SES-VRQoL are calculated using the "National Eye Institute 25-Item Visual Functioning Questionnaire" (NEI-VFQ-25). Both scales range from 0 to 100, 0 corresponds to the sum that would be achieved if a participant had answered all items with the worst performance, and 100 corresponds to the sum of all items answered with the best possible performance. Distance-corrected visual acuity was measured in both eyes. Univariable and multivariable linear regression analyses were conducted to identify ophthalmic and sociodemographic predictors of VRQoL.

resultsA total of 10,152 participants (mean age 54.2 years; 49.2% female) were included in the analysis. The mean visual functioning decreased from 89.6 (IQR: 81.3, 95.1) at baseline to 85.9 (IQR: 79.2, 92.6) at 5-year follow-up in the VFS (p < 0.001). Participants' socio-emotional well-being remained the same from baseline to 5-year follow-up in the SES-VRQoL. In multivariable linear regression analysis, older age (0.03, p = 0.002) and female gender (-1.00, p < 0.001) were associated with a VFS change. Higher baseline socioeconomic status was associated with a slightly positive increase in VFS (0.07, p = 0.001). Deterioration of visual acuity in the better and worse-seeing eye was associated with negative VFS change over 5 years (better-seeing eye: -5.41, p < 0.001, worse-seeing eye: -7.35, p < 0.001). Baseline socioeconomic status was associated with SES-VRQoL change (0.06, p < 0.001). The negative change in visual acuity showed an association with negative SES-VRQoL in the better (-4.15, p < 0.001) and worse-seeing eye (-3.75, p < 0.001). Stratification of the regression models by age and gender showed greater reductions in VFS scores with visual acuity changes in participants aged 65 years or older and a more pronounced decrease in female participants over 5 years.

conclusionsThis study demonstrated an association between visual acuity change and change in VRQoL over 5 years, with a greater decrease in female participants and participants aged 65 years or older. The better-seeing eye and the worse-seeing eye both had an impact on changes in VRQoL. KEY MESSAGES: What is known Previous studies have predominantly used cross-sectional designs to investigate the correlation between visual acuity and vision-related quality of life, with limited insights into how visual acuity changes over time affect vision-related quality of life in a large cohort. What is new This study demonstrates that visual acuity changes significantly impact VRQoL over a 5-year period, with a notable decrease observed in female participants and those aged 65 years or older. Analysis reveals both the better-seeing and worse-seeing eye contribute to changes in VRQoL, highlighting the necessity of comprehensive visual assessments in both eyes for a more accurate understanding of VRQoL outcomes.