Associations of Mortality With Ocular Disorders and an Interventionof High-Dose Antioxidants and Zinc in the Age-Related Eye Disease Study: AREDS Report No. 13
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OBJECTIVE: To assess the association of ocular disorders and high doses of antioxidants or zinc with mortality in the Age-Related Eye Disease Study (AREDS). METHODS: Baseline fundus and lens photographs were used to grade the macular and lens status of AREDS participants. Participants were randomly assigned to receive oral supplements of high-dose antioxidants, zinc, antioxidants plus zinc, or placebo. Risk of all-cause and cause-specific mortality was assessed using adjusted Cox proportional hazards models. RESULTS: During median follow-up of 6.5 years, 534 (11%) of 4753 AREDS participants died. In fully adjusted models, participants with advanced age-related macular degeneration (AMD) compared with participants with few, if any, drusen had increased mortality (relative risk [RR], 1.41; 95% confidence interval [CI], 1.08-1.86). Advanced AMD was associated with cardiovascular deaths. Compared with participants having good acuity in both eyes, those with visual acuity worse than 20/40 in 1 eye had increased mortality (RR, 1.36; 95% CI, 1.12-1.65). Nuclear opacity (RR, 1.40; 95% CI, 1.12-1.75) and cataract surgery (RR, 1.55; 95% CI, 1.18-2.05) were associated with increased all-cause mortality and with cancer deaths. Participants randomly assigned to receive zinc had lower mortality than those not taking zinc (RR, 0.73; 95% CI, 0.61-0.89). CONCLUSIONS: The decreased survival of AREDS participants with AMD and cataract suggests that these conditions may reflect systemic rather than only local processes. The improved survival in individuals randomly assigned to receive zinc requires further study.
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Zinc alone decreased the incidence of blindness due to age-related macular degeneration in 25% of these elderly subjects.
“Zinc alone has decreased the incidence of blindness due to age-related macular degeneration in 25% of these elderly subjects, and, most important, increased longevity has also been reported in those treated with zinc (41,42).”
From Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress (2007) · cites this paper as [42]
Increased longevity has been reported in elderly subjects treated with zinc.
“Zinc alone has decreased the incidence of blindness due to age-related macular degeneration in 25% of these elderly subjects, and, most important, increased longevity has also been reported in those treated with zinc (41,42).”
From Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress (2007) · cites this paper as [42]
In the Age-Related Eye Disease Study, only the zinc-supplemented group showed increased longevity, with a 27% reduction in mortality risk in subjects 55-81 years of age who received only therapeutic zinc daily.
“Interestingly, only the zinc-supplemented group showed increased longevity (74). The risk of mortality was reduced by 27% in the Age-Related Eye Disease Study Group studies in subjects 55–81 y of age who received only therapeutic zinc daily.”
From Discovery of Human Zinc Deficiency: Its Impact on Human Health and Disease (2013) · cites this paper as [74]
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- Authors
- AREDS Research Group
- Affiliations
- Emmes (United States) (US)
- Corresponding author
- AREDS Research Group
- Venue
- Archives of Ophthalmology
- Publisher
- American Medical Association (AMA)
- Published
- 2004-05-01
- Volume
- 122
- Issue
- 5
- Pages
- 716
- ISSN
- 0003-9950 (ISSN-L)
- PMC
- PMC1473208
- OpenAlex
- W1548644132
- Cited by
- 215
- References
- 32
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 9 · 2020: 8 · 2019: 8 · 2018: 6 · 2017: 11 · 2016: 11 · 2015: 7 · 2014: 15 · 2013: 8 · 2012: 15
- FWCI
- 18.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1z01ey000394-01)
- National Eye Institute (Z01 EY000394-03)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
- Keywords
- eye diseases, mortality, age-related macular degeneration, drusen, visual acuity, nuclear lens opacity, cataract surgery, cataract, antioxidants, zinc supplementation, all-cause mortality, cardiovascular mortality, cancer mortality
- MeSH terms
- Aged, Aged, 80 and over, Aging, Antioxidants, Ascorbic Acid, Cataract, Cataract Extraction, Cause of Death, Drug Therapy, Combination, Female, Humans, Macular Degeneration, Male, Middle Aged, United States, Vision Disorders, Vitamin E, Zinc Oxide, Survival Rate, Proportional Hazards Models, beta Carotene, Visually Impaired Persons, Persons with Visual Disabilities
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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