Gergana Zlateva, PhD (New York, NY),* Emmett T. Cunningham, MD, PhD, MPH (South San Francisco, CA), Jonathan C. Javitt, MD, MPH (Washington, DC),* Steve Zhou, PhD (Bridgewater, NJ),* Sonali N. Shah, BS, MPH (New York, NY)*


In addition to the burden imposed by vision loss, elderly AMD patients are at increased risk for chronic conditions and comorbidities that also negatively affect their health and quality of life. We compared the prevalence and relative risks of comorbidities in patients with wet AMD versus in those without wet AMD using data from Medicare analytic files.


This observational retrospective study consisted of 2003 Medicare beneficiaries in the standard 5% analytic sample excluding those in Medicare Managed Care plans. Wet AMD patients included those =?65 years of age with an AMD diagnoses code (N = 17,916). The same number of patients, matched for age and gender, served as controls. Thirteen of the most common comorbid conditions were identified based on the general population (cancer, diabetes, lipids, nervous system, hypertension, stroke, respiratory system, GI disorder, skin disorders, musculoskeletal disease, depression, external injury, and bone fracture).
Prevalence rates were calculated and odds ratios generated using logistic regression.


The prevalence of 12 of the 13 comorbidities was significantly higher in patients with versus without wet AMD (P < 0.001 for each comparison); the exception was bone fracture where rates were similar. For example, the odds ratio (OR) of cancer was 1.478 (p<0.0001) for AMD subjects compared to controls. Similarly, AMD patients were at higher risk of hypertension (OR=1.32, p<0.0001), stroke (OR=1.12, p<0.0001), respiratory disorders (OR=1.28, p<0.0001), disorder of lipid metabolism (OR=1.36, p<0.0001), GI disorders (OR=1.23, p<0.0001), and depression (OR=1.11, p<0.0001) among others.


The prevalence of most common comorbid conditions is significantly higher in patients with wet AMD than in those without wet AMD. This high morbidity burden in patients with wet AMD suggests that they should be treated with the safest possible medications, i.e., those with the fewest side effects and the least association with cardiovascular risks, in order to help maintain their optimal health.
* Financial interest disclosed