Incidence of late AMD quadruples per decade of age in white Americans

Issue: December 10, 2015

The incidence of age-related macular degeneration increased exponentially with age in white American subjects, and women had a higher annual incidence of late AMD compared with men, according to a study.

Perspective from Paul Boeke, MD

“Estimating AMD incidence from prevalence allows better characterization at older ages and by AMD subtype where longitudinal data from incidence studies are limited,” the study authors said.

The authors conducted a systematic review and meta-analysis of 74 prospective cohort studies published in Medline, Embase and Web of Science on the incidence and prevalence of AMD in white populations with European ancestry.

Fourteen publications based on 10 population studies contained relevant incidence data and were included for analysis.

The authors culled data on age- and sex-specific incidence of late AMD, geographic atrophy and neovascular AMD, year of study recruitment, AMD grading method and continent.

“Incidence rates from the review agreed with those derived from prevalence, but the latter were based on more data, especially at older ages and by AMD subtypes,” the authors said.

The annual incidence of late AMD in white Americans age 50 years and older, estimated from prevalence, was 3.5 per 1,000. The incidence was equivalent to 293,000 new cases among white Americans annually.

Annual incidence rates among people age 50 years and older were 1.9 per 1,000 for geographic atrophy and 1.8 per 1,000 for neovascular AMD.

Incidence rates roughly quadrupled per decade of age.

The estimated total number of new cases rose rapidly from age 50 years to mid-80s and subsequently began to fall.

Late incidence of AMD was 38% greater among women than among men. – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

Perspective

Paul Boeke, MD

As a recent residency graduate, the finding of quadrupled incidence per decade of age from the Rudnicka article affirmed my medical training that macular degeneration is, as my residency retina attending put it, a “disease of birthdays.”
The article and Rudnicka also affirm a lot of personal concerns and questions about the future of my chosen specialty. Most physicians age with their patient population, whereas the majority of my future patients just received their AARP cards, including the tail end of a baby boomer generation that turned 50 last year. Compounded by ever expanding life expectancies, now age 79 in the U.S., how do we prepare to treat this quickly growing patient population, particularly in the face of a health care system that is going to demand more cost efficiency and be increasingly transparent as last year’s New York Times article suggests?
The future lay in the continued dogged pursuit of cost-effective, long-lasting treatment, a future I am excited to witness.

Paul Boeke, MD

Retina fellow, University of Wisconsin

Disclosures: Boeke reports no relevant financial disclosures.

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Source:

Rudnicka AR, et al. Am J Ophthalmol. 2015;doi:10.1016/j.ajo.2015.04.003.