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OBJECTIVE: To assess the risk of nursing home admission in a representative sample of older, visually impaired, community-dwelling people 75 years and older living in Great Britain. DESIGN: Prospective study. SETTING: General practices (n = 53). PARTICIPANTS: Participants in the Medical Research Council trial of assessment and management of older people in the community (N = 14 037). MAIN OUTCOME MEASURE: Nursing home admission (nursing or residential care). RESULTS: After a mean of 4 years' follow-up, 14.1% of visually impaired participants were living in nursing homes (95% confidence interval [CI], 11.9%-16.3%; age- and sex-adjusted risk ratio, 1.47 [95% CI, 1.25-1.73]). Adjusting for a wide range of confounding factors eliminated this significant association (risk ratio, 1.08 [95% CI, 0.91-1.28]). CONCLUSIONS: The association between visual impairment and risk of nursing home admission was eliminated after controlling for a wide range of other confounding factors and comorbidities. This underlines the importance of taking a wider view of an older person's health rather than focusing on a single impairment or disability.
Dr. J.R. Evans, International Centre for Eye Health, Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK. Jennifer.evans@lshtm.ac.uk