Prevalence and ROC curve analysis of associated factors of presbyopia among adults in southeast China: the Fujian Eye Study

Abstract

Purpose With the improvement of people's living standards, the demand for eye health is no longer limited to being visible, but more importantly, being able to see clearly. The aging population has led to increasing attention on presbyopia worldwide. Our study aims to reveal the prevalence and related factors of presbyopia among urban and rural adults over 50 years of Fujian Province Southern China. Methods A population-based cross-sectional study was performed to evaluate the prevalence and related factors of presbyopia among urban and rural adults over 50 years in more than 50 communities of Fujian Province Southern China from May 2018 to October 2019. A total of 8211 residents aged over 50 years underwent a questionnaire and a series related examinations. PNVA was measured using logarithmic visual acuity chart at a distance of 30cm, and presbyopia was defined as PNVA worse than 20/50. Results A total of 8033 residents did the examination of near visual acuity in this study. Of these, 5509 (68.6%) had presbyopia, of whom 3428 (62.2%) were female, 3057 (55.4%) were from urban area, 4300 (78.0%) were from coastal region. The prevalence of presbyopia was 68.6%. Univariate regression showed that presbyopia was correlated with female, older age, less educated, lower income, higher spherical equivalent refraction (SE), living in rural area, smoking, alcohol consumption and tea consumption, and was independent with geographic location. While multiple regression found that presbyopia was correlated with older age, less educated, lower income and higher SE, while sex, degree of urbanization, smoking, alcohol consumption and tea consumption were not statistically significantly associated with presbyopia any more. Finally, we used ROC curves to detect the credibility of the four associated factors, and the results showed that age and SE can accurately predict presbyopia, while education and income levels have poor credibility. Conclusion There was a significant burden of presbyopia in southeast China, which suggested more investment in accessible services and policy to enhance eye health on elderly with refractive error.