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Open Access Research article

Hospital admissions in older people with visual impairment in Britain

Jennifer R Evans12*, Liam Smeeth2 and Astrid E Fletcher2

Author Affiliations

1 International Centre for Eye Health, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UK

2 Non-Communicable Disease Epidemiology Unit, LSHTM, Keppel Street, London, WC1E 7HT, UK

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BMC Ophthalmology 2008, 8:16  doi:10.1186/1471-2415-8-16

Published: 11 September 2008

Abstract

Background

We aimed to assess the risk of hospital admission associated with visual impairment in a representative sample of older people living in the community in Britain.

Methods

    Design:
Prospective study of hospital admission in a population-based sample of community dwelling people aged 75 years and above in Britain.
    Setting:
53 general practices.
    Participants:
14,394 participants in the MRC Trial of Assessment and Management of Older people in the Community.
    Main outcome measure:
Hospital admission.

Results

Visually impaired older people had 238.7 admissions/1000 person-years compared to 169.7 admissions/1000 person-years in people with good vision: age and sex adjusted rate ratio (RR) 1.32 (95% CI 1.19 to 1.47). Adjusting for a wide range of potential explanatory factors largely eliminated this association: RR 1.06 (95% CI 0.94 to 1.20). However, adjusting for a more limited range of confounding factors, excluding those factors possibly a consequence of reduced vision, left a modest increased risk: RR 1.19 (95% CI 1.06 to 1.34).

Conclusion

The association between visual impairment and rate of hospital admission can be attributed to higher levels of co-morbidity and reduced functional ability among people with reduced vision. Visual impairment is likely to be an important contributor to reduced functional ability, but other factors may also be involved.