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Impacts and Costs of AMD
Impact of AMD on The Ageing Population
Global prevalence estimates (% of people with the disease in the global population) indicate that AMD affects 9% of people aged between 45–85 years worldwide. Globally, it is estimated that approximately 196 million people will have AMD by 2020, and this number is expected to increase to 288 million by 2040 as a result of population ageing1
A recent update from the Vision Loss Expert Group found that in 2020 1.85 million people were blind due to AMD and another 6.23 million presented with moderate or severe vision impairment – MSVI. From 2000 to 2020 there was a reduction in the crude prevalence of AMD –related blindness globally and an increase in AMD-related MSVI2.
Impact on Patients
The loss of visual function associated with AMD negatively impacts patients’ quality of life, and deprives them of their independence and social interaction.Visual impairment associated with AMD can prevent people from carrying out a number of everyday activities including: reading (e.g. books, newspapers, lists, medicine labels), recognising faces, driving, using public transport, general mobility, socialising, shopping and caring for themselves/dependants. The loss of ability to perform everyday tasks can lead to loss of independence, social isolation and absence from work. As visual impairment worsens, independence and overall quality of life decline. Even mild visual impairment can have a substantial impact on vision-related quality life.25–27
Vision loss that occurs with AMD also has a major impact on emotional well-being, and those affected often report feelings of frustration, annoyance and fear of coping with everyday life28. Anxiety and depression in AMD patients has been well documented.29,30
People with AMD are also at a greater risk of falls and secondary injuries that may occur as a result of them, such as hip fractures. Some studies have found that the risk of falls increase as visual acuity worsens, which underlines the importance of visual rehabilitation for people affected by AMD.31–33
Impact on Caregivers
Caring for somebody with loss of visual function due to AMD is associated with a substantial burden on the carer. In many cases, spouses and/or other family members are called upon to provide physical and emotional support. Caregivers of people with late AMD are at high risk of emotional distress and often face significant disruption to their own lives.34–38
A study by Macular Disease Foundation Australia (MDFA) that surveyed 500 caregivers of people with neovascular AMD, revealed a high rate of psychological distress among carers, with over half reporting a negative state of mind. More than half also had to make changes to other areas of their lives (e.g. participation in social activities or retirement plans) as a consequence of caring for someone with neovascular AMD. In this study, the level of dependence and presence of comorbidity chronic illnesses in the care recipient were independent predictors of the caregiver experiencing psychological distress.34
Cost of AMD
AMD is associated with a significant economic burden to patient, caregiver and society. As the proportion of people affected by AMD is forecast to increase considerably over the next few decades due to population ageing 1 it is important to quantify the economic cost of AMD in order to inform future healthcare planning. The economic cost of AMD may be categorised into direct and indirect costs39,40:
Direct Costs
These include ophthalmological care, including physician visits and costs of therapies (e.g. vitamin supplements, intravitreal injections, imaging), etc., counselling, supportive equipment (low vision aids), transportation costs and resource utilisation associated with co-morbid conditions (e.g. depression, falls and other injuries).
Indirect Costs
These include loss of productivity and absence from work for both patients and their caregivers and general cost to society reflected by the negative impact on a country’s gross domestic product (GDP).
Retina International has carried out research on both the economic burden o late stage AMD and the impact on patients. Study reports can be found on the research section of the website.