AMD Predicts Poorer Overall Survival in Older Women

by U.S. Medicine

April 7, 2016

PORTLAND, OR — What is the association between age-related macular degeneration (AMD) and all-cause and cause-specific mortality in a population of older women?

Answering that question was the goal of a prospective cohort study at four U.S. clinical centers. Results were published in the Journal of the American Geriatric Society.1

A study team led by Kaiser Permanente researchers and including participation from the Minneapolis VAMC used a random sample of 1,202 women — mean age 79.5 — with graded fundus photographs at the Year 10 visit of the Study of Osteoporotic Fractures. Researchers graded 45 degree steoscopic fundus photographs for presence of AMD and severity — early vs. late. Death certificates were used to confirm vital status.

According to the findings, prevalence of any AMD was 40.5% at baseline, with 441 patients (36.7%) having early AMD and 46 (3.8%) having late AMD. Over 15 years of follow-up, cumulative mortality was 51.6%.

Results indicate no significant association between AMD presence or severity and all-cause or cause-specific mortality. In women younger than 80, after adjusting for covariates, late AMD was associated with cardiovascular disease (CVD) mortality, with a hazard ratio of 2.61, however.

In women 80 and older, early AMD was associated with all-cause, HR 1.39 and non-CVD, noncancer mortality, HR 1.45. In fact, any AMD was associated with all-cause, HR 1.42 and CVD, HR 1.45 mortality in women 80 and older.

“AMD is a predictor of poorer survival in women, especially those aged 80 and older,” study authors note. “Determination of shared risk factors may identify novel pathways for intervention that may reduce the risk of both conditions.”

1 Pedula KL, Coleman AL, Yu F, Cauley JA, Ensrud KE, Hochberg MC, Fink HA, Hillier TA; Study of Osteoporotic Fractures Research Group. Age-related macular degeneration and mortality in older women: the study of osteoporotic fractures. J Am Geriatr Soc. 2015 May;63(5):910-7. doi: 10.1111/jgs.13405. Epub 2015 May 4. PubMed PMID: 25941039; PubMed Central PMCID: PMC4439266.

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