Cataract: Health Disparity for Older African-Americans

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African Americans have more visual impairment from cataract, and less cataract surgery, compared to Caucasians. While risk factors for cataract have been studied, specific determinants of cataract incidence and progression, and time to cataract surgery, comparing factors and their importance within racial groups has not been done. The aims of this research are: to determine the incidence and progression of cataract in an older population-based sample of African Americans compared to Caucasians; to determine predictive factors and their relative importance for incidence and progression; and to determine factors predicting time to cataract surgery for those with visually disabling cataract in each racial group. Prospective data have already been collected as part of the NIA funded SEE project; baseline, 2, 6, and 8 year data are available from the 2520 participants on UV exposure, alcohol and tobacco use, medications, diseases such as hypertension and diabetes, and other key risk factors. Ocular photographs were taken at baseline and graded for presence and severity of cortical, nuclear, and posterior sub-capsular cataract, and taken but not yet graded for follow up visits. Vision and physical function measures were taken at each round, enabling analyses of functional impact of cataract and predictors of seeking cataract surgery. Models will be constructed to determine risk factors for cataract incidence and progression, testing for interactions by racial groups. Level of visual impairment due to cataract and effect on physical function within racial groups will be used to model triggers for subsequent cataract surgery. Such data will increase knowledge of cataractogenic mechanisms within racial groups, and provide more understanding of disparites in seeking cataract surgery. These data will advance the goal of reducing health disparity in visual disability from cataract among older African Americans.