Risk of type 2 diabetes mellitus among adults aging with vision impairment: The role of the neighborhood environment.
Philippa Clarke, Anam M Khan, Neil Kamdar and 5 others
PMID 36130856WHAT IT FOUND
Among adults with vision impairment, more broadband, optical stores, grocery stores, or fitness centers were linked to lower type 2 diabetes risk.
More hospitals were linked to higher risk. In older adults, more high-speed roads or intersections were linked to higher risk.
Key findings
01During follow-up, 3,302 of 22,719 adults with vision impairment were diagnosed with incident type 2 diabetes, a 14.5% rate.
02Higher broadband internet availability was associated with lower type 2 diabetes risk in both age groups: 46% lower among adults under 65 and 33% lower among adults 65 or older.
03Among adults 65 or older with vision impairment, living in areas with more high-speed roads was associated with a 22% increased risk, and more street intersections was associated with a 26% increased risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample came from a private payer claims database, so it may not represent publicly insured adults with vision impairment. Individual income, education, and race were removed from the data, so the analysis could adjust only for area-level socioeconomic status. Area-level socioeconomic status is not a strong proxy for a person's own income, education, or race. ZIP code was used as a proxy for the neighborhood environment. Some neighborhood features were highly related, so the models could not show which feature mattered most when several were present. The study observed associations. It did not prove that a neighborhood feature caused diabetes risk to change. The researchers could not tell whether adults with vision impairment actually used the nearby resources. Diabetes status came from insurance claims, including a single physician-diagnosed encounter, not from a clinical assessment described in the paper.
Declared interests
The supplied text does not include an author conflict-of-interest declaration. The article is tagged as supported by NIH extramural and U.S. government non-PHS funding.
The easy way to misread this
Do not conclude that building broadband, grocery stores, fitness centers, or optical stores will reduce diabetes risk. The study observed associations in a claims cohort and did not test these neighborhood changes or know whether adults with vision impairment used them.