Key points
- The National Health and Aging Trends Study (NHATS) is a nationally representative in-person survey of Medicare beneficiaries aged 65 years and older with a focus on age-related health.
- The VEHSS analysis is based on 6,327 participants included in Round 12, which was conducted in 2022.
- NHATS includes three vision measures: (1) distance presenting visual acuity, (2) near-distance presenting visual acuity, and (3) contrast sensitivity.
Where the data come from
NHATS began surveying a nationally representative sample of Medicare beneficiaries aged 65 years and older in 2011. Surveys are conducted each year through in-person interviews. Vision-related tests of distance acuity, near-distance acuity, and contrast sensitivity are conducted with the aid of a computer tablet. Because participants wear their usual eyewear for vision assessments, acuity estimates are based on presenting acuity.
Analysis overview
We analyzed NHATS data to calculate the prevalence of the categories and subgroups below. Data are based on NHATS round 12, which was collected in 2022. We defined subgroup thresholds based on the VEHSS case definitions for Vision Loss and Blindness. Some of these thresholds are different from those used in the .
Because the data are designed to be nationally representative of Medicare beneficiaries, our analysis was weighted using final survey weights. Cluster and strata design variables were used to account for NHATS’ complex survey design.
Vision Indicator Definitions
Vision Category
Respondent Subgroups
Vision in Better-Seeing Eye*
Measured distance visual acuity
Presenting with normal vision
20/12.5 to >20/32
Presenting with any vision loss
≤20/32
Presenting with visual impairment
20/32 to >20/200
Presenting with mild visual impairment
20/32 to >20/80
Presenting with moderate visual impairment
20/80 to >20/200
Presenting with U.S.-defined blindness
≤20/200
Missing presenting acuity
No acuity measure
Measured near visual acuity
Presenting with normal near visual acuity
20/12.5 to >20/32
Presenting with any near visual acuity loss
≤20/32
Contrast sensitivity
Normal contrast sensitivity
>1.55 logCS
Any contrast sensitivity loss
≤1.55 logCS
Mild contrast sensitivity loss
>1.37 logCS to ≤1.55 logCS
Severe contrast sensitivity loss
≤1.37 logCS
*logCS: log contrast sensitivity
Data definitions
Age group
- 65+
- 65-69
- 70-74
- 75-79
- 80-84
- 85-89
- 90+
Sex
- Both sexes
- Female
- Male
Race/ethnicity
- All race/ethnicity
- Black (non-Hispanic)
- Hispanic
- White (non-Hispanic)
- Other (Am Indian/Asian/Native Hawaiian/Pacific Islander/other specify, non-Hispanic)
- Unknown
Risk factors
- Diabetes (self-report)
- Smoking (self-report)
- Residing in Residential Care Setting
Data type
- Crude prevalence
- Age-adjusted prevalence
Available geographic levels
- National
Potential limitations
Limitations of this analysis include the following:
- No consensus thresholds for contrast sensitivity exist in the current scientific literature. Because our goal was to provide more granular prevalence estimates, we categorized contrast sensitivity into four levels. However, this is not a widely used convention, and no widely accepted definitions exist for this term.
- These data focus on older adults and cannot be generalized to the overall U.S. population.
- These data have a relatively small sample size, which results in wide confidence intervals and high suppression rates.