{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T09:31:30Z","timestamp":1794562290104,"version":"4.9.1"},"reference-count":50,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ajo.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Ophthalmology"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.ajo.2026.05.025","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T16:09:23Z","timestamp":1779466163000},"page":"304-312","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Prevalence of Chronic Health Conditions by Vision Difficulty Status Among Middle-Aged and Older Adults, United States, 2020-2024"],"prefix":"10.1016","volume":"289","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4840-9705","authenticated-orcid":false,"given":"JEONG HA (STEPH)","family":"CHOI","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8534-5408","authenticated-orcid":false,"given":"SUSAN A.","family":"CARLSON","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MEDA E","family":"PAVKOV","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8193-1848","authenticated-orcid":false,"given":"SAMANTHA L.","family":"PIERCE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARY","family":"PUCKETT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3400-8804","authenticated-orcid":false,"given":"JOHN D.","family":"OMURA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajo.2026.05.025_bib0001","doi-asserted-by":"crossref","first-page":"E106","DOI":"10.5888\/pcd17.200130","article-title":"Prevalence of multiple chronic conditions among US adults, 2018","volume":"17","author":"Boersma","year":"2020","journal-title":"Prev Chronic Dis"},{"key":"10.1016\/j.ajo.2026.05.025_sbref0002","series-title":"National Health Expenditure Data: Historical","year":"2025"},{"key":"10.1016\/j.ajo.2026.05.025_bib0003","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-014-0181-7","article-title":"Visual impairment is associated with physical and mental comorbidities in older adults: a cross-sectional study","volume":"12","author":"Court","year":"2014","journal-title":"BMC Med"},{"issue":"10","key":"10.1016\/j.ajo.2026.05.025_bib0004","doi-asserted-by":"crossref","first-page":"4297","DOI":"10.1167\/iovs.08-1826","article-title":"Traditional and novel cardiovascular risk factors for retinal vein occlusion: the multiethnic study of atherosclerosis","volume":"49","author":"Cheung","year":"2008","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"4","key":"10.1016\/j.ajo.2026.05.025_bib0005","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1167\/iovs.15-18373","article-title":"Diabetes, triglyceride levels, and other risk factors for Glaucoma in the National Health and Nutrition Examination Survey 2005-2008","volume":"57","author":"Ko","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"10.1016\/j.ajo.2026.05.025_bib0006","doi-asserted-by":"crossref","first-page":"E43","DOI":"10.5888\/pcd19.220027","article-title":"Cardiovascular disease risk factors in US adults with vision impairment","volume":"19","author":"Mendez","year":"2022","journal-title":"Prev Chronic Dis"},{"issue":"3","key":"10.1016\/j.ajo.2026.05.025_bib0007","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3928\/23258160-20240110-01","article-title":"Relationship between disease and treatment factors in diabetes with vision difficulty: a cross-sectional, population-based analysis","volume":"55","author":"Zajner","year":"2024","journal-title":"Ophthalm Surg Lasers Imaging Retina"},{"issue":"2","key":"10.1016\/j.ajo.2026.05.025_bib0008","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1001\/archophthalmol.2008.551","article-title":"Serum cystatin C level, kidney disease markers, and incidence of age-related macular degeneration: the Beaver Dam eye study","volume":"127","author":"Klein","year":"2009","journal-title":"Arch Ophthalmol"},{"issue":"3","key":"10.1016\/j.ajo.2026.05.025_bib0009","doi-asserted-by":"crossref","first-page":"748","DOI":"10.2337\/dc20-0413","article-title":"Risk of blindness among patients with diabetes and newly diagnosed diabetic retinopathy","volume":"44","author":"Wykoff","year":"2021","journal-title":"Diabetes Care"},{"issue":"7","key":"10.1016\/j.ajo.2026.05.025_bib0010","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1016\/S0161-6420(94)31191-2","article-title":"Open-angle glaucoma and older-onset diabetes. The Beaver Dam eye study","volume":"101","author":"Klein","year":"1994","journal-title":"Ophthalmology"},{"key":"10.1016\/j.ajo.2026.05.025_bib0011","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ajo.2020.01.002","article-title":"Visual impairment and major eye diseases in Chronic Kidney disease: the National Health and Nutrition Examination Survey, 2005-2008","volume":"213","author":"Zhu","year":"2020","journal-title":"Am J Ophthalmol"},{"issue":"7","key":"10.1016\/j.ajo.2026.05.025_bib0012","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1001\/jamaophthalmol.2019.1052","article-title":"Association between progression of retinopathy and concurrent progression of kidney disease: findings from the chronic renal insufficiency cohort (CRIC) study","volume":"137","author":"Grunwald","year":"2019","journal-title":"JAMA Ophthalmol"},{"issue":"9","key":"10.1016\/j.ajo.2026.05.025_bib0013","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1001\/archophthalmol.2012.1800","article-title":"Retinopathy and Chronic Kidney Disease in the chronic renal insufficiency cohort (CRIC) study","volume":"130","author":"Grunwald","year":"2012","journal-title":"Arch Ophthalmol"},{"issue":"10","key":"10.1016\/j.ajo.2026.05.025_bib0014","doi-asserted-by":"crossref","first-page":"3159","DOI":"10.1093\/ndt\/gfr022","article-title":"Kidney function, albuminuria and age-related macular degeneration in NHANES III","volume":"26","author":"Weiner","year":"2011","journal-title":"Nephrol Dial Transplant"},{"issue":"5","key":"10.1016\/j.ajo.2026.05.025_bib0015","doi-asserted-by":"crossref","first-page":"867","DOI":"10.2215\/CJN.08271109","article-title":"Prevalence of ocular fundus pathology in patients with chronic kidney disease","volume":"5","author":"Grunwald","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4","key":"10.1016\/j.ajo.2026.05.025_bib0016","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.ajo.2013.12.023","article-title":"Dry eye in the Beaver Dam offspring study: prevalence, risk factors, and health-related quality of life","volume":"157","author":"Paulsen","year":"2014","journal-title":"Am J Ophthalmol"},{"issue":"5","key":"10.1016\/j.ajo.2026.05.025_bib0017","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.ajo.2005.05.025","article-title":"Correlation between dry eye and rheumatoid arthritis activity","volume":"140","author":"Fujita","year":"2005","journal-title":"Am J Ophthalmol"},{"issue":"3","key":"10.1016\/j.ajo.2026.05.025_bib0018","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1001\/archopht.1987.01060030092033","article-title":"Cancer-associated retinopathy","volume":"105","author":"Thirkill","year":"1987","journal-title":"Arch Ophthalmol"},{"issue":"4\u20135","key":"10.1016\/j.ajo.2026.05.025_bib0019","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3109\/08820538.2011.588657","article-title":"Cancer-associated retinopathy: update on pathogenesis and therapy","volume":"26","author":"Shildkrot","year":"2011","journal-title":"Semin Ophthalmol"},{"issue":"2","key":"10.1016\/j.ajo.2026.05.025_bib0020","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.ajo.2011.06.028","article-title":"Depression and visual functioning in patients with ocular inflammatory disease","volume":"153","author":"Qian","year":"2012","journal-title":"Am J Ophthalmol"},{"issue":"2","key":"10.1016\/j.ajo.2026.05.025_bib0021","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.ophtha.2015.07.009","article-title":"High prevalence of untreated depression in patients accessing low-vision services","volume":"123","author":"Nollett","year":"2016","journal-title":"Ophthalmology"},{"issue":"7","key":"10.1016\/j.ajo.2026.05.025_bib0022","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1001\/jamaophthalmol.2019.1085","article-title":"Longitudinal associations of self-reported vision impairment with symptoms of anxiety and depression among older adults in the United States","volume":"137","author":"Frank","year":"2019","journal-title":"JAMA Ophthalmol"},{"issue":"2","key":"10.1016\/j.ajo.2026.05.025_bib0023","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1080\/08998280.2024.2301917","article-title":"Associations between depression and diabetic retinopathy in the National Health and Nutrition Examination Survey, 2011 to 2018","volume":"37","author":"Kalva","year":"2024","journal-title":"Baylor Univers Med Center Proceed"},{"issue":"12","key":"10.1016\/j.ajo.2026.05.025_bib0024","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1093\/gerona\/glab157","article-title":"The Longitudinal Association of Vision impairment with transitions to cognitive impairment and dementia: findings from the aging, demographics and memory study","volume":"76","author":"Ehrlich","year":"2021","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"Suppl 3","key":"10.1016\/j.ajo.2026.05.025_bib0025","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.3233\/JAD-132570","article-title":"Severe diabetic retinal disease and dementia risk in type 2 diabetes","volume":"42","author":"Exalto","year":"2014","journal-title":"J Alzheimers Dis"},{"issue":"1","key":"10.1016\/j.ajo.2026.05.025_bib0026","article-title":"Dual sensory impairment in older adults and risk of dementia from the GEM study","volume":"12","author":"Hwang","year":"2020","journal-title":"Alzheimers Dement (Amst)"},{"issue":"5","key":"10.1016\/j.ajo.2026.05.025_bib0027","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.10734","article-title":"Longitudinal changes in hearing and visual impairments and risk of dementia in older adults in the United States","volume":"5","author":"Hwang","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"3","key":"10.1016\/j.ajo.2026.05.025_bib0028","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.1558","article-title":"Prevalence of concurrent functional vision and hearing impairment and association with dementia in community-dwelling Medicare beneficiaries","volume":"4","author":"Kuo","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"10452","key":"10.1016\/j.ajo.2026.05.025_bib0029","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","article-title":"Dementia prevention, intervention, and care: 2024 report of The Lancet Standing Commission","volume":"404","author":"Livingston","year":"2024","journal-title":"Lancet"},{"key":"10.1016\/j.ajo.2026.05.025_bib0030","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ajo.2017.06.038","article-title":"The prevalence of chronic conditions and poor health among people with and without vision impairment, aged \u226565 years, 2010-2014","volume":"182","author":"Crews","year":"2017","journal-title":"Am J Ophthalmol"},{"issue":"6S2","key":"10.1016\/j.ajo.2026.05.025_bib0031","doi-asserted-by":"crossref","first-page":"S143","DOI":"10.1016\/j.amepre.2017.07.019","article-title":"Prevalence and medical costs of chronic diseases among adult Medicaid beneficiaries","volume":"53","author":"Chapel","year":"2017","journal-title":"Am J Prev Med"},{"issue":"10","key":"10.1016\/j.ajo.2026.05.025_bib0032","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jamaophthalmol.2014.2213","article-title":"Association of vision loss and work status in The United States","volume":"132","author":"Sherrod","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"10.1016\/j.ajo.2026.05.025_bib0033","unstructured":"National Center for Health Statistics. National Health Interview Survey. Centers for Disease Control and Prevention (CDC). Accessed July, 2025. https:\/\/www.cdc.gov\/nchs\/nhis\/index.html"},{"key":"10.1016\/j.ajo.2026.05.025_bib0034","doi-asserted-by":"crossref","DOI":"10.5888\/pcd10.120239","article-title":"Defining and measuring chronic conditions: imperatives for research, policy, program, and practice","volume":"10","author":"Goodman","year":"2013","journal-title":"Prev Chronic Dis"},{"issue":"3","key":"10.1016\/j.ajo.2026.05.025_bib0035","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.ecl.2016.04.004","article-title":"Regarding obesity as a disease: evolving policies and their implications","volume":"45","author":"Kyle","year":"2016","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"7","key":"10.1016\/j.ajo.2026.05.025_bib0036","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1001\/jamaophthalmol.2016.1284","article-title":"Visual impairment and blindness in adults in the United States: demographic and geographic variations from 2015 to 2050","volume":"134","author":"Varma","year":"2016","journal-title":"JAMA Ophthalmol"},{"issue":"Suppl 2","key":"10.1016\/j.ajo.2026.05.025_bib0037","first-page":"S40","article-title":"Preface to the expert panel report (Comprehensive Version Which Includes Systematic Evidence Review, Evidence Statements, And Recommendations)","volume":"22","year":"2014","journal-title":"Obesity (Silver Spring)"},{"key":"10.1016\/j.ajo.2026.05.025_bib0038","doi-asserted-by":"crossref","DOI":"10.5888\/pcd22.240539","article-title":"Trends in multiple chronic conditions among US adults, by life stage, behavioral risk factor surveillance system, 2013-2023","volume":"22","author":"Watson","year":"2025","journal-title":"Prev Chronic Dis"},{"issue":"Suppl 1","key":"10.1016\/j.ajo.2026.05.025_bib0039","article-title":"Gender differences in views about cognitive health and healthy lifestyle behaviors among rural older adults","volume":"49","author":"Wu","year":"2009","journal-title":"Gerontologist"},{"issue":"1","key":"10.1016\/j.ajo.2026.05.025_bib0040","doi-asserted-by":"crossref","first-page":"P35","DOI":"10.1093\/geronb\/59.1.P35","article-title":"Adaptation to disability among middle-aged and older adults: the role of assimilative and accommodative coping","volume":"59","author":"Boerner","year":"2004","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"issue":"2","key":"10.1016\/j.ajo.2026.05.025_bib0041","doi-asserted-by":"crossref","DOI":"10.1016\/j.dhjo.2023.101553","article-title":"Counting Disability in the National Health Interview Survey and Its Consequence: comparing the American Community Survey to the Washington Group Disability Measures","volume":"17","author":"Landes","year":"2024","journal-title":"Disabil Health J"},{"issue":"5","key":"10.1016\/j.ajo.2026.05.025_bib0042","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1001\/jamaophthalmol.2013.2597","article-title":"Association between depression and functional vision loss in persons 20 years of age or older in the United States, NHANES 2005-2008","volume":"131","author":"Zhang","year":"2013","journal-title":"JAMA Ophthalmol"},{"issue":"2","key":"10.1016\/j.ajo.2026.05.025_bib0043","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.ophtha.2007.04.049","article-title":"Type 2 Diabetes Mellitus and the Risk of Open-angle Glaucoma the Los Angeles Latino Eye Study","volume":"115","author":"Chopra","year":"2008","journal-title":"Ophthalmology"},{"issue":"6","key":"10.1016\/j.ajo.2026.05.025_bib0044","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/S0002-9394(98)00280-3","article-title":"Diabetes, cardiovascular disease, selected cardiovascular disease risk factors, and the 5-year incidence of age-related cataract and progression of lens opacities: the Beaver Dam eye study","volume":"126","author":"Klein","year":"1998","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.ajo.2026.05.025_bib0045","series-title":"The Surgeon General\u2019s Call to Action to Control Hypertension","year":"2020"},{"key":"10.1016\/j.ajo.2026.05.025_bib0046","unstructured":"Million Hearts. Community Health Workers and Million Hearts. U.S. Department of Health and Human Services. Accessed August 12, 2025, https:\/\/millionhearts.hhs.gov\/files\/MH_CommHealthWorker_Factsheet_English.pdf."},{"key":"10.1016\/j.ajo.2026.05.025_bib0047","unstructured":"National Association of Community Health Centers. Effects of Uncontrolled Blood Pressure. National Association of Community Health Centers. Accessed August 12, 2025. https:\/\/www.nachc.org\/resource\/effects-of-uncontrolled-blood-pressure\/."},{"key":"10.1016\/j.ajo.2026.05.025_bib0048","unstructured":"CancerCare. Eye and Vision Concerns During Cancer Treatment. CancerCare. Accessed August 12, 2025. https:\/\/www.cancercare.org\/publications\/466-eye_and_vision_concerns_during_cancer_treatment."},{"issue":"3","key":"10.1016\/j.ajo.2026.05.025_bib0049","doi-asserted-by":"crossref","DOI":"10.1016\/j.dhjo.2022.101320","article-title":"US adults with visual impairments meeting 24-H movement guidelines: updated national prevalence estimates","volume":"15","author":"Ross","year":"2022","journal-title":"Disabil Health J"},{"issue":"2","key":"10.1016\/j.ajo.2026.05.025_bib0050","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/EDE.0000000000000775","article-title":"How healthy are survey respondents compared with the general population?: using survey-linked death records to compare mortality outcomes","volume":"29","author":"Keyes","year":"2018","journal-title":"Epidemiology"}],"container-title":["American Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002939426002709?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002939426002709?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T09:17:11Z","timestamp":1794561431000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002939426002709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":50,"alternative-id":["S0002939426002709"],"URL":"https:\/\/doi.org\/10.1016\/j.ajo.2026.05.025","relation":{},"ISSN":["0002-9394"],"issn-type":[{"value":"0002-9394","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Prevalence of Chronic Health Conditions by Vision Difficulty Status Among Middle-Aged and Older Adults, United States, 2020-2024","name":"articletitle","label":"Article Title"},{"value":"American Journal of Ophthalmology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajo.2026.05.025","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}