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Abstract
Background Cataract, glaucoma and age-related macular degeneration (AMD) are major causes of visual impairment. As these are age-related conditions, the prevalence of associated visual impairment is anticipated to increase as the population ages. However, age–period–cohort effects on the disease burden have not been investigated.
Methods This was a population-based study using aggregated data from the Global Burden of Disease Study 2019. Age–period–cohort analysis was conducted using age-standardised prevalence rates (ASPRs) of visual impairment caused by cataract, glaucoma and AMD as disease burden indicator.
Results In 2019, the estimated global ASPRs of visual impairment due to cataract, glaucoma and AMD were 1207.9, 94.7 and 96.8 per 100 000 people, respectively. Between 1990 and 2019, the global visual impairment ASPRs for glaucoma and AMD declined by 15.4% and 2.0%, respectively, whereas that for cataract increased by 5.0%. Wide heterogeneity was observed in age–period–cohort effects on ASPRs across different Sociodemographic Index (SDI) regions. Low-middle SDI regions had the largest ASPR reductions for all three eye diseases and showed improvement in both period and cohort effects. In contrast, in high-middle SDI regions, visual impairment ASPRs significantly increased during the study period with unfavourable patterns.
Conclusions The wide heterogeneity in age–period–cohort effects reflects different stages of societal transition and vision health. The unfavourable trends in age–period–cohort effects on disease prevalence identified in specific groups provide key information that may be used to identify priority groups in need of treatment and prevention.
- Public health
- Epidemiology
Data availability statement
Data are available in a public, open access repository. The data that support the findings of this study are publicly available from the GBD 2019 study at the Institute for Health Metrics and Evaluation website (https://vizhub.healthdata.org/gbd-results).
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Data availability statement
Data are available in a public, open access repository. The data that support the findings of this study are publicly available from the GBD 2019 study at the Institute for Health Metrics and Evaluation website (https://vizhub.healthdata.org/gbd-results).
Footnotes
SZ and YZ are joint senior authors.
JC and YZ contributed equally.
Contributors Conceptualisation: YZhuo and SZ. Methodology: JC and YZhu. Verification of the underlying data: ZL and XZ. Writing—original draft: JC and YZhu. Writing—review and editing: YZhuo and SZ. YZhuo accepts full responsibility for the work and the conduct of the study, had access to the data, and controlled the decision to publish.
Funding This work was supported by the National Key R&D Project of China (2020YFA0112701), National Natural Science Foundation of China (82171057), Science and Technology Program of Guangzhou, China (202206080005), Major Science and Technology Project of Zhongshan City (2022A1007) and Shenzhen Science and Technology Program (KCXFZ20211020163813019). The funding bodies had no role in the design of the study; in the collection, analysis or interpretation of the data; nor in writing the manuscript.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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