Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

NIOSHTIC-2 Publications Search

Search Results

Assessment of the effect of visual impairment on mortality through multiple health pathways: structural equation modeling.

Authors
Christ-SL; Lee-DJ; Lam-BL; Zheng-DD; Arheart-KL
Source
Investig Ophthalmol Vis Sci 2008 Aug; 49(8):3318-3323
NIOSHTIC No.
20034311
Abstract
PURPOSE. To estimate the direct effects of self-reported visual impairment (VI) on health, disability, and mortality and to estimate the indirect effects of VI on mortality through health and disability mediators. METHODS. The National Health Interview Survey (NHIS) is a population-based annual survey designed to be representative of the U.S. civilian noninstitutionalized population. The National Death Index of 135,581 NHIS adult participants, 18 years of age and older, from 1986 to 1996 provided the mortality linkage through 2002. A generalized linear structural equation model (GSEM) with latent variable was used to estimate the results of a system of equations with various outcomes. Standard errors and test statistics were corrected for weighting, clustering, and stratification. RESULTS. VI affects mortality, when direct adjustment was made for the covariates. Severe VI increases the hazard rate by a factor of 1.28 (95% CI: 1.07-1.53) compared with no VI, and some VI increases the hazard by a factor of 1.13 (95% CI: 1.07-1.20). VI also affects mortality indirectly through self-rated health and disability. The total effects (direct effects plus mediated effects) on the hazard of mortality of severe VI and some VI relative to no VI are hazard ratio (HR) 1.54 (95% CI: 1.28-1.86) and HR 1.23 (95% CI: 1.16-1.31), respectively. CONCLUSIONS. In addition to the direct link between VI and mortality, the effects of VI on general health and disability contribute to an increased risk of death. Ignoring the latter may lead to an underestimation of the substantive impact of VI on mortality.
Keywords
Vision-disorders; Mortality-data; Mortality-rates; Mortality-surveys; Mathematical-models; Statistical-analysis; Risk-factors
Contact
Odum Institute, University of North Carolina, Chapel Hill, NC 27599-3355
CODEN
IOVSDA
Publication Date
20080801
Document Type
Journal Article
Email Address
slchrist@email.unc.edu
Funding Type
Grant
Fiscal Year
2008
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-003915
Issue of Publication
8
ISSN
0146-0404
Source Name
Investigative Opthalmology & Visual Science
State
FL; NC
Performing Organization
University of Miami School of Medicine, Miami, Florida
TOP