Longitudinal Incidence of Adverse Outcomes of Age-Related Macular Degeneration

Objective: To describe the visual, functional, and general health complication rates associated with age-related macular degeneration (AMD) in a nationally representative longitudinal sample of elderly persons. Methods: This is a longitudinal retrospective cohort study (January 1, 1994-December 31, 2004) that used Medicare claims data. We identified beneficiaries aged 68 years and older who had newly diagnosed AMD in 1994 (n = 32 702) and age-, sex-, and race-matched controls who had routine eye surveillance and no diagnosis of AMD throughout the observational period (n = 32 702). Main outcome measures included cumulative incidence of vision loss, blindness, hip fracture, depression, and nursing home placement and prevalence of 16 general health conditions. Results: Elderly individuals with newly diagnosed AMD had higher rates of blindness, vision loss, depression, hip fracture, and residence in a nursing home than those without AMD during a 10-year follow-up period. Individuals with AMD also had a higher prevalence of 11 of 16 general health conditions compared with controls. Conclusions: Individuals aged 68 years and older with AMD had higher rates of visual and functional impairments and had more illness than controls. Our findings demonstrate the substantial resource commitment of caring for the multifaceted health issues of persons diagnosed with AMD.