TOPLINE:

In a cohort of US adults, visual impairment was independently associated with a 36% increased risk for all-cause mortality, driven primarily by conditions not linked to cardiovascular disease or cancer. 

METHODOLOGY:

• Researchers conducted a population-based cohort study using data from the National Health and Nutrition Examination Survey (2001-2008) to assess whether visual impairment was more strongly linked to noncardiovascular and noncancer deaths than to cardiovascular or cancer deaths.
• They included 11,938 US adults aged 40 years or older (52.4% women) who had visual acuity measured while wearing their usual glasses or contacts; visual impairment was defined as visual acuity worse than 20/40 in the eye with better vision and was present in 9.9% of participants at baseline.
• The primary outcome was all-cause mortality, with secondary outcomes including noncardiovascular, noncancer; cardiovascular; and cancer mortality.
• Mortality was assessed through December 31, 2019, over a mean follow‑up duration of 13.2 years.

TAKEAWAY:

• During follow‑up, 23.6% of participants died, including 48.2% of those with visual impairment vs 21.8% of those without.
• Visual impairment was associated with a 36% higher risk for all-cause mortality (adjusted hazard ratio [HR], 1.36; P < .001) and a 55% higher risk for noncardiovascular, noncancer mortality (adjusted HR, 1.55; 95% CI, 1.30-1.84; P < .001).
• Visual impairment showed a modest association with the risk for cardiovascular mortality (adjusted HR, 1.33; P = .033) but no significant association with the risk for death from cancer (P = .912).
• The relative increase in the risk for overall mortality associated with visual impairment was greater in younger adults than in older adults.

IN PRACTICE:

The findings suggest the mortality burden associated with visual impairment “extends beyond cardiovascular pathways and is largely concentrated in noncardiovascular, noncancer causes of death, emphasizing vision loss as a marker of broader systemic and functional vulnerability rather than a predominantly vascular risk factor,” the researchers reported.

SOURCE:

The study was led by Taemin Kim, of The Warren Alpert Medical School of Brown University in Providence, Rhode Island. It was published online on April 22, 2026, in American Journal of Ophthalmology.

LIMITATIONS:

Visual impairment was assessed at a single baseline examination, and changes in visual acuity over follow-up could not be captured. Residual confounding by unmeasured variables such as frailty, depression, social isolation, or access to eye care remained possible. Determining the reason for death relied on death certificate data, which may have been imprecise, particularly for heterogeneous noncardiovascular, noncancer categories. 

DISCLOSURES:

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors reported no relevant financial disclosures.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.