Vision impairment, depressive symptoms, and risk of incident coronary events: a prospective cohort study

Q: What are the key findings of this study?

Baseline self-reported vision impairment was associated with a 40% higher risk of incident coronary heart disease (HR 1.40; 95% CI 1.08-1.80) over a median 12-year follow-up.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Incident coronary heart disease (CHD) in relation to vision impairment (n=6906). Intervention: Baseline self-reported vision impairment (fair or poor vision) vs. No vision impairment (excellent, very good, or good vision). Primary outcome: Incident coronary heart disease (first self-report of physician-diagnosed myocardial infarction and/or angina) (HR 1.40, 95% CI 1.08-1.80, p=0.01).

Q: What does this research mean for the field?

Baseline self-reported vision impairment and vision deterioration are associated with a significantly higher risk of incident coronary heart disease in older adults. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Yang Liu; Junyan Ling; Guangli Sun; Fangfang Yu; 祝军华

doi:10.1038/s41598-026-75981-4

October 21, 2026Scientific ReportsOpen Access

Vision impairment, depressive symptoms, and risk of incident coronary events: a prospective cohort study

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Key result

Baseline vision impairment is linked to ~40% higher risk of incident CHD over 12 years.

HR 1.40
95% CI 1.08-1.80
P=0.01
n=6,906

Why the study?

Vision impairment is a common yet underrecognized age-related condition, and its association with coronary heart disease risk and the potential mediating role of depressive symptoms remained unclear.

Does self-reported vision impairment or vision deterioration increase the risk of incident coronary heart disease in adults aged ≥50 years?

Key Points

To examine the longitudinal associations between baseline self-reported vision status, vision transitions, and incident coronary heart disease, and to evaluate whether depressive symptoms mediate these relationships.
Prospective cohort study using data from 6,906 adults aged ≥ 50 years in the English Longitudinal Study of Ageing followed for a median of 12 years (2004–2023).
Multivariable Cox proportional hazards models and restricted cubic splines assessed baseline vision status and vision transitions between Waves 2 and 3, adjusting for sociodemographic, health, and behavioral covariates.
Exploratory path-based mediation analyses estimated the indirect effect of depressive symptoms on the association between vision impairment and incident coronary events.
During follow-up, 502 incident cases of coronary heart disease occurred; baseline vision impairment was associated with a 40% higher risk of disease (HR 1.40; 95% CI 1.08–1.80; P = 0.01).
Participants who developed vision impairment had a 55% higher risk of coronary heart disease (HR 1.55; 95% CI 1.12–2.15), those with persistent impairment had a higher risk (HR 1.72; 95% CI 1.16–2.55), and each one-point higher mean vision score reduced risk by 21% (HR 0.79; 95% CI 0.69–0.90; P < 0.001).
Depressive symptoms statistically mediated 16.7% of the baseline vision impairment association on the log-hazard scale (indirect effect 0.090; 95% CI 0.038–0.144; P = 0.002), though mediation was inconclusive for vision transitions.

Study Design

Type

Cohort (n=6,906)

Multicenter

Yes

Structured PICO

Does self-reported vision impairment or vision deterioration increase the risk of incident coronary heart disease in adults aged ≥50 years?

P

Population

6,906 community-dwelling adults in England aged 50 years or older (mean age 65.1 years, 57.7% female), free of prior myocardial infarction or angina at baseline, followed for a median of 12 years.

E

Exposure

Self-reported vision impairment (rated fair or poor while wearing corrective lenses if applicable) at baseline (Wave 2), vision transitions between Waves 2 and 3 (persistent no-VI, no-VI to VI, VI to no-VI, persistent VI), and ordinal vision score (ranging from 1 [poor] to 5 [excellent]).

C

Comparator

No vision impairment (self-reported eyesight rated excellent, very good, or good) at baseline, or persistent no vision impairment across Waves 2 and 3.

O

Outcome

Incident coronary heart disease (CHD), defined as the first self-report during follow-up of a physician diagnosis of myocardial infarction (including heart attack or coronary thrombosis) and/or angina over a median follow-up of 12 years.composite

Main Result

Hazard Ratio: 1.4 (95% CI 1.08–1.8)

Absolute Event Rate: 9.2% vs 7.01%

p-value: p=0.01

Self-reported vision impairment and deteriorating vision in adults aged 50 and older are independently associated with a 40% to 55% higher risk of incident coronary heart disease, partially mediated by depressive symptoms.

Limitations

Observational design precludes causal inference and cannot exclude residual confounding or reverse causation
Self-reported assessment of both vision status and depressive symptoms may introduce misclassification and reporting bias
Incident coronary heart disease was ascertained via self-reported physician diagnosis without medical record linkage or clinical adjudication
Potential selection bias from differential attrition in the longitudinal vision-transition analyses
Mediation analyses were exploratory and relied on strong assumptions regarding unmeasured confounding
Study population was predominantly White middle-aged and older adults in England, limiting generalizability to other populations
Self-reported vision status reflects participants’ perceived visual function and is not an objective assessment of visual acuity or clinically diagnosed eye disease
Exact diagnosis dates for incident CHD were unavailable, so event dates were assigned to the first interview at which MI and/or angina was newly reported
Depressive symptoms mediation was interpreted as a statistical rather than causal decomposition
Subgroup analyses were considered exploratory given the number of comparisons performed

Implication

Vision screening may flag higher CHD risk in adults ≥50; leaves open whether interventions alter outcomes.

Abstract

Vision impairment (VI) is a common yet underrecognized age-related condition, but its association with coronary heart disease (CHD) risk remains unclear. Using data from 6,906 adults aged ≥ 50 years in the English Longitudinal Study of Ageing (2004–2023), we examined the associations of baseline self-reported vision status and vision transitions between Waves 2 and 3 with incident CHD and explored whether depressive symptoms statistically accounted for part of these associations. During a median follow-up of 12 years, 502 incident CHD cases were identified. Participants with baseline VI had a 40% higher risk of CHD (hazard ratio [HR] 1.40; 95% confidence interval [CI] 1.08–1.80), and those whose vision deteriorated had a 55% higher subsequent risk (HR 1.55; 95% CI 1.12–2.15). Each one-point higher mean vision score was linked to a 21% lower CHD risk (HR 0.79; 95% CI 0.69–0.90). Exploratory mediation analyses suggested that depressive symptoms statistically accounted for a modest proportion of the baseline VI–CHD association. Poorer self-reported vision and deterioration were associated with a higher subsequent risk of CHD. Depressive symptoms statistically accounted for a modest proportion of the baseline association, suggesting that perceived visual decline may mark broader cardiovascular vulnerability in later life.

Discussion

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Cite This Study

Liu et al. (2026) conducted a cohort in Incident coronary heart disease (CHD) in relation to vision impairment (n=6,906). Baseline self-reported vision impairment (fair or poor vision) vs. No vision impairment (excellent, very good, or good vision) was evaluated on Incident coronary heart disease (first self-report of physician-diagnosed myocardial infarction and/or angina) (HR 1.40, 95% CI 1.08-1.80, p=0.01). Baseline self-reported vision impairment was associated with a 40% higher risk of incident coronary heart disease (HR 1.40; 95% CI 1.08-1.80) over a median 12-year follow-up.

synapsesocial.com/papers/6ad9e562f67b53d0945659ce https://doi.org/10.1038/s41598-026-75981-4

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Vision impairment, depressive symptoms, and risk of incident coronary events: a prospective cohort study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Vision impairment, depressive symptoms, and risk of incident coronary events: a prospective cohort study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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