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Brief Report
April 2018

Association of Social Support Network Size With Receipt of Cataract Surgery in Older Adults

Author Affiliations
  • 1Center for Eye Policy and Innovation, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
  • 2National Clinician Scholars Program, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  • 3Department of Internal Medicine, University of Michigan, Ann Arbor
  • 4Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  • 5Michigan Center on the Demography of Aging, Institute for Social Research, University of Michigan, Ann Arbor
JAMA Ophthalmol. 2018;136(4):423-427. doi:10.1001/jamaophthalmol.2018.0244
Key Points

Question  Are older adults who have fewer people in their social support networks less likely to undergo cataract surgery?

Findings  In this cohort study using nationally representative survey data, older adults with fewer family members in their social support network were less likely to receive cataract surgery.

Meaning  Smaller social support networks may represent a barrier to receiving cataract surgery among older adults in the United States.

Abstract

Importance  Cataract-related vision impairment is an important public health issue that tends to affect older adults. Little is known about the association between older adults’ social support networks and their likelihood of receiving cataract surgery.

Objective  To determine if older adults with smaller social support networks are less likely to receive cataract surgery.

Design, Setting, and Participants  Retrospective cohort study. The National Health and Aging Trends Study, a nationally representative US survey, administered annually from 2011 to 2015 to a cohort of Medicare beneficiaries 65 years and older with no cataract surgery prior to the start of the study.

Main Outcomes and Measures  Multivariable logistic regression was performed to evaluate if the number of persons in an individual’s social support network influenced whether that individual received cataract surgery during a given year of the study.

Results  Overall, 3448 participants were interviewed from 2011 to 2015 for a total of 9760 observations. Of these observations, 3084 (weighted, 38.81%; 95% CI, 37.28-40.35) were aged 70 to 74 years, 5211 (weighted, 52.32%; 95% CI, 50.19-54.44) were women; 5899 (weighted, 78.53%; 95% CI, 76.29-80.61) were white, 2249 (weighted, 9.55%; 95% CI, 8.45-10.78) were black, 537 (weighted, 7.18%; 95% CI, 5.88-8.73) were Hispanic, and 303 (weighted, 4.74%; 95% CI, 3.56-62.9) reported other races. Medicare beneficiaries with smaller social support networks (0-2 individuals) were less likely to receive cataract surgery in a given year (adjusted odds ratio, 0.60; 95% CI, 0.37-0.96) than those with larger support networks (≥3 individuals). The adjusted predicted proportion of Medicare beneficiaries undergoing cataract surgery was 4.7% (95% CI, 2.7%-6.7%) and 7.5% (95% CI, 6.9%-8.1%) for those with small and large social support networks, respectively. Having fewer non–spouse/partner family members in the support network was associated with decreased odds of receiving cataract surgery (adjusted odds ratio, 0.60; 95% CI, 0.43-0.85), but having spouses/partners (adjusted odds ratio, 0.97; 95% CI, 0.77-1.22) and nonfamily members (adjusted odds ratio, 0.90; 95% CI, 0.72-1.11) did not have a significant association.

Conclusions and Relevance  Medicare beneficiaries with fewer non–spouse/partner family members in their social support networks were less likely to receive cataract surgery. These findings suggest that attention should be given to patients with smaller support networks to ensure that they receive cataract surgery when it is indicated.

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