Age-Period-Cohort Analysis of Global Prevalence of Blindness and Vision Loss: Findings From The Global Burden of Disease Study 2019

Abstract

Abstract Objective To quantify age, period, and cohort effect on the global secular trend of prevalence of blindness and vision impairment (BVI) based on the age-period-cohort (APC) model. Methods Data on global BVI were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 database. Annual percentage change of age-standardized prevalence rate (ASPR) of BVI was estimated by assuming a linear relationship between natural logarithm of ASPR of disease with time. The prevalence of BVI was evaluated from age, period, and cohort effects based on the APC model with intrinsic estimator. Results Global prevalence number of BVI was 353.2 million in 1990 and increased to 713.9 million in 2019, but with an ASPR declined at a speed of -0.14% (95% CI: -7.49–7.8%) per year from 1990 to 2019. The APC model showed that the prevalence of BVI increased with age and period but decreased with cohorts. Changes in each cause (age-related macular degeneration, cataract, glaucoma, refractive disorders, near-vision loss, and other vision loss) are consistent in the overall upward or downward trend of the age, period, and cohort effects. Conclusions Global prevalence of BVI has significant age, period and cohort effects. The risk of vision impairment increases with age and period, however, it decreases with the cohort. Cost-effective prevention and control should be implemented more in the older population at high risk.