Global Disability in Older Adults with Age-Related Macular Degeneration
Keywords:
Adulto mayor; degeneración macular asociada a la edad; discapacidad visual; geriatría; gerontología; calidad de vida.Abstract
Introduction: Age-related macular degeneration is one of the leading causes of visual disability in older adults. Its repercussions go beyond the ophthalmological sphere and affect functionality, mental health, and quality of life.
Objective: To analyze scientific evidence on disability in older adults with Age-related macular degeneration, with emphasis on its multidimensional impact and the main strategies for assessment and intervention from the geriatric and gerontological perspective.
Methods: A narrative review was conducted in PubMed/MEDLINE, SciELO, and Scopus. Review articles, meta-analyses, and observational studies published between 2019 and 2024 were prioritized.
Results: The prevalence of Age-related macular degeneration increases exponentially with age and affects more than 8 % of individuals over 65 years. Its impact includes loss of autonomy in basic and instrumental activities of daily living, increased risk of falls, depression, social isolation, and frailty. Comprehensive Geriatric Assessment allows quantification of functional and psychosocial impact. Effective interventions include clinical-ophthalmological management, visual rehabilitation, environmental adaptation, psychological support, and strengthening of family and community networks.
Conclusions: Age-related macular degeneration in older adults represents a global public health problem and a chronic disease with functional and social repercussions that favor the emergence of geriatric syndromes.
Keywords: Older adult; age-related macular degeneration; visual disability; geriatrics; gerontology; quality of life.
Downloads
References
1. World Health Organization. World report on vision. Geneva: WHO; 2019 [Acceso: 16 marzo 2026]. Disponible en: https://www.who.int/publications/i/item/world-report-on-vision
2. Rein DB, Wittenborn JS, Burke-Conte Z, Patel N, Saaddine J, Ehrlich JR. Prevalence of age-related macular degeneration in the United States in 2019. JAMA Ophthalmol [Internet]. 2022 [Acceso: 16 marzo 2026];140(12):1202–8. Disponible en: https://doi.org/10.1001/jamaophthalmol.2022.4401
3. Fleckenstein M, Keenan TDL, Guymer RH, Chakravarthy U, Schmitz-Valckenberg S, Klaver CC, et al. Age-related macular degeneration. Nat Rev Dis Primers [Internet]. 2021 [Acceso: 2 marzo 2026];7(31):1–29. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33958600/
4. Wong WL, Su X, Li X, Cheung CMG, Klein R, Cheng CY, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040. Lancet Glob Health [Internet]. 2014 [Acceso: 16 marzo 2026];2(2):e106–16. Disponible en: https://doi.org/10.1016/S2214-109X(13)70145-1
5. Oficina Nacional de Estadísticas e Información (ONEI). Anuario Demográfico de Cuba 2023. La Habana: ONEI; 2024 [Acceso: 27 febrero 2026]. Disponible en: https://www.onei.gob.cu/anuario-estadistico-de-cuba-2023
6. Fleckenstein M, Keenan TDL, Guymer RH, Chakravarthy U, Schmitz-Valckenberg S, Klaver CC, Wong WT, Chew EY. Age-related macular degeneration. Nat Rev Dis Primers [Internet]. 2021 May 6 [Acceso: 1 abril 2026];7(1):31. Disponible en: https://doi.org/10.1038/s41572-021-00265-2
7. Jin H, Zhou Y, Stagg BC, Ehrlich JR. Asociación entre la discapacidad visual y la mayor prevalencia de caídas en adultos mayores de EE. UU. [Internet]. J Am Geriatr Soc. 2024 mayo [consultado el 10 jul 2024];72(5):1373-83. Disponible en: https://doi.org/10.1111/jgs.18879
8. Schultz NM, Bhardwaj S, Barclay C, Gaspar L, Schwartz J. Global Burden of Dry Age-Related Macular Degeneration: A Targeted Literature Review [Internet]. Clin Ther. 2021 Oct [consultado el 10 jul 2024];43(10):1792-1818. Disponible en: https://doi.org/10.1016/j.clinthera.2021.08.011
9. Guymer RH, Campbell TG. Age-related macular degeneration. Lancet [Internet]. 2023 Apr 29 [Acceso: 2 abril 2026];401(10386):1459–72. Disponible en: https://doi.org/10.1016/S0140-6736(22)02609-5
10. American Academy of Ophthalmology Retina/Vitreous Panel. Age-Related Macular Degeneration Preferred Practice Pattern® [Internet]. Ophthalmology. 2022 Jan [consultado el 10 jul 2024];129(1):P1-P45. Disponible en: https://www.aao.org/education/preferred-practice-pattern/age-related-macular-degeneration-ppp
11. GBD 2021 Global AMD Collaborators. Global burden of vision impairment due to age-related macular degeneration, 1990-2021, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Glob Health [Internet]. 2025 Jul [consultado el 10 jul 2024];13(7):e1175-e1190. Disponible en: https://doi.org/10.1016/S2214-109X(25)00143-3
12. Klaver CC, van Leeuwen R, Vingerling JR, Hofman A, de Jong PT, Silva R, Guymer RH, et al. Epidemiology of age-related macular degeneration: a review of population-based studies. Eur J Epidemiol [Internet]. 2020 [Acceso: 26 marzo 2026];35(6):539–56. Disponible en: http://dx.doi.org/10.1023/A:1025643303914
13. Khan H, Aziz AA, Sulahria H, Khan H, Ahmed A, Choudhry N, Khanani AM. Emerging treatment options for geographic atrophy secondary to age-related macular degeneration. Clin Ophthalmol [Internet]. 2023 [Acceso: 2 abril 2026];17:321–7. Disponible en: https://doi.org/10.2147/OPTH.S367089
14. Chew EY, Clemons T, SanGiovanni JP, Danis R, Domalpally A, McBee W, et al. The Age-Related Eye Disease Study 2 (AREDS2): study design and baseline characteristics (AREDS2 report number 1). Ophthalmology [Internet]. 2012 Nov [citado 2026 Abr 2];119(11):2282–9. Disponible en: https://doi.org/10.1016/j.ophtha.2012.05.027
15. Csaky KG, Miller JML, Martin DF, Johnson MW. Drug Approval for the Treatment of Geographic Atrophy: How We Got Here and Where We Need to Go. Am J Ophthalmol [Internet]. 2024 Jul 1 [citado 2026 Abr 2];263:231-9. Disponible en: https://doi.org/10.1016/j.ajo.2024.02.021
16. Keenan TDL, Agrón E, Keane PA, Domalpally A, Chew EY, Age-Related Eye Disease Study Research Group, et al. Oral Antioxidant and Lutein/Zeaxanthin Supplements Slow Geographic Atrophy Progression to the Fovea in Age-Related Macular Degeneration. Ophthalmology [Internet]. 2025 Jan [citado 2026 Abr 2];132(1):14-29. Disponible en: https://doi.org/10.1016/j.ophtha.2024.07.014
17. Varma R, Kim JS, Burkemper B, Lee PP, Hays RD, Choudhury F, Azen SP, et al. Visual impairment and quality of life in older adults. Ophthalmology [Internet]. 2021 [Acceso: 26 marzo 2026];128(7):1000–8. Disponible en: https://doi.org/10.1001/jamaophthalmol.2016.1284
18. Cimarolli VR, Casten RJ, Rovner BW, Heyl V, Wahl HW, Boerner K, Massof RW, et al. Depression and anxiety in patients with AMD: longitudinal outcomes. Am J Ophthalmol [Internet]. 2022 [Acceso: 26 marzo 2026];235:1–9. Disponible en: https://doi.org/10.2147/OPTH.S80489
19. Sherif M, Dutta NA, Eldessouky EI, Kabil MM, El-Koumy HAE, Mehta NN, et al. Artificial intelligence-based assessment of treatment response in wet age-related macular degeneration using paired OCT angiography. Sci Rep [Internet]. 2026 Apr 1 [Acceso: 2 abril 2026];16:42999. Disponible en: https://doi.org/10.1038/s41598-026-42999-7
20. Mitchell P, Liew G, Gopinath B, Rochtchina E, Wang JJ, Foran S, Tan AG, et al. AMD and social isolation: population-based evidence. Invest Ophthalmol Vis Sci [Internet]. 2020 [Acceso: 26 febrero 2026];61(4):45. Disponible en: https://doi.org/10.1038/s41598-018-22963-w
21. Butt T, Dunbar HM, Morris S, Orr S, Rubin GS. Patient and public preferences for health states associated with AMD. Optom Vis Sci [Internet]. 2013 Aug [Acceso: 2 abril 2026];90(8):855–60. Disponible en: https://doi.org/10.1097/OPX.0b013e3182962318
22. Domalpally A, Haas AM, Chandra S, VanderZee B, Dimopoulos IS, Keenan TDL, et al. Photoreceptor assessment in age-related macular degeneration. Eye (Lond) [Internet]. 2025 Feb [Acceso: 2 abril 2026];39(2):284–95. Disponible en: https://doi.org/10.1038/s41433-024-03462-x
23. Taylor DJ, Jones L, Binns AM, Crabb DP. "You've got dry macular degeneration, end of story": a qualitative study into the experience of living with non-neovascular age-related macular degeneration. Eye [Internet]. 2020 [Acceso: 2 abril 2026];34(3):461–73. Disponible en: https://doi.org/10.1038/s41433-019-0445-8
24. Casten RJ, Rovner BW. Management of depression in patients with age-related macular degeneration. Curr Opin Ophthalmol [Internet]. 2021 [Acceso: 26 marzo 2026];32(3):234–9. Disponible en: https://doi.org/10.1177/0145482X0810201003
25. Flores R, Carneiro Â, Vieira M, Tenreiro S, Seabra MC. Age-related macular degeneration: physiopathology, management and future perspectives. Ophthalmologica [Internet]. 2021 Jun 15 [Acceso: 2 abril 2026];244(6):495–511. Disponible en: https://doi.org/10.1159/000517520
26. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med [Internet]. 2006 [Acceso: 26 marzo 2026];355(14):1419–31. Disponible en: https://doi.org/10.1056/NEJMoa054481
27. Ferris FL, Wilkinson CP, Bird A, Chakravarthy U, Chew EY, Csaky K, Klein R, et al. Clinical classification of age-related macular degeneration. Ophthalmology [Internet]. 2013 [Acceso: 26 marzo 2026];120(4):844–51. Disponible en: https://doi.org/10.1016/j.ophtha.2012.10.036
28. Heesterbeek TJ, Lorés-Motta L, Hoyng CB, Lechanteur YTE, den Hollander AI. Risk factors for progression of age-related macular degeneration. Ophthalmic Physiol Opt [Internet]. 2020 Feb 25 [Acceso: 2 abril 2026];40(2):140–60. Disponible en: https://doi.org/10.1111/opo.12675
29. Tian M, Zhang B. Identification of risk factors for the progression of age-related macular degeneration: a systematic review and meta-analysis of cohort studies. Front Med [Internet]. 2025 [Acceso: 2 abril 2026];12:1544765. Disponible en: https://doi.org/10.3389/fmed.2025.1544765
30. Tran E, Shah N, Xu R, Aly M, Malvankar-Mehta MS. Effects of low-vision rehabilitation on reading speed and depression in age-related macular degeneration: a systematic review and meta-analysis. Br J Vis Impair [Internet]. 2025 [Acceso: 2 abril 2026];43(1):175–92. Disponible en: https://doi.org/10.1177/02646196231217414
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Yani González Cabrera, Mayra Rosa Carrasco García, Elia Rosa Lemus Lago
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
