Associations of Life’s Essential 8 with age-related macular degeneration

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Background/aims To investigate the association of the Life’s Essential 8 (LE8) score with age-related macular degeneration (AMD) in a Chinese population and synthesise existing evidence. Methods A total of 256 age-matched and sex-matched case–control pairs were included. Conditional logistic regression models were used to estimate multivariable-adjusted ORs and 95% CIs. Findings were subsequently integrated with prior studies using random-effects meta-analysis. Results The LE8 score was inversely associated with AMD, with an OR of 0.31 (95% CI 0.15 to 0.64) for the highest versus the lowest category. An inverse association was observed for the behavioural subscale score (OR: 0.16; 95% CI 0.08 to 0.34) but not for the biological subscale score (OR: 0.86; 95% CI 0.47 to 1.56). LE8 and behavioural subscale scores showed linear dose-response associations with AMD. The population-attributable fractions (PAFs) for theoretical shifts to the high LE8 category and high behavioural subscale category were 50.0% and 48.2%, respectively. Among the individual component scores, significant inverse associations were observed for physical activity and smoking status. The largest PAF was observed for physical activity. In the meta-analysis, higher LE8 scores were inversely associated with AMD, with an overall effect estimate of 0.60 (95% CI 0.38 to 0.97). Conclusions Higher LE8 scores were inversely associated with AMD, with supportive evidence from the meta-analysis. Among the LE8 components, physical activity and smoking abstinence showed the strongest inverse associations. Given the uncertain temporality and potential for reverse causality, further prospective studies are needed to confirm these findings.