Assessing the Impact of Vision Impairment on Health-Related Quality of Life Among Community-Dwelling Older Population in Hong Kong: Preliminary Results

OBJECTIVES: To clarify the relationship between vision impairment (VI) and health-related quality of life (HRQoL) in a community-dwelling elderly population in order to aid the construction of cost-utility decision models on VI interventions. In this report, we discuss the approach taken and present interim results.

METHODS: Using a stratified selection strategy, a sample of individuals ≥ 50 years old was randomly drawn from those who had undergone a community-based comprehensive eye examination without referral to an eye specialist between 2015 and 2017. Recruited subjects attended a follow-up comprehensive eye examination in 2022-24. HRQoL was measured using the European Quality of Life-5 Dimensions 5 Levels (EQ-5D-5L) questionnaire. Distance VI was based on the better-seeing eye with presenting visual acuity worse than 6/12 and was further classified as correctable VI if the best-corrected visual acuity (BCVA) was equal to or better than 6/12, and as uncorrectable VI if the BCVA was worse than 6/12.

RESULTS: Five hundred and eighty participants were included with the mean (SD) age of 72.1 (5.0) years and 52.0% female. The overall prevalence of VI was 16.9%, with 13.1% for correctable VI and 3.8% for uncorrectable VI. Utility scores were 0.91 ±0.14 for participants without VI and 0.88 ±0.17 for those with VI, specifically 0.90 ±0.13 for correctable VI and 0.84 ±0.25 for uncorrectable VI, with no significant differences across groups. Compared to participants without VI, those with VI were more likely to report problems with mobility, self-care and usual activities (P<0.05).

CONCLUSIONS: Those subjects with VI, especially uncorrectable VI, tended to have lower EQ-5D utility scores, and more likely to have problems with mobility, self-care and usual activities. The final analysis will need to consider biases introduced by this interim analysis.