To assess the association of ocular disorders and high doses of antioxidantsor zinc with mortality in the Age-Related Eye Disease Study (AREDS).
Baseline fundus and lens photographs were used to grade the macularand lens status of AREDS participants. Participants were randomly assignedto receive oral supplements of high-dose antioxidants, zinc, antioxidantsplus zinc, or placebo. Risk of all-cause and cause-specific mortality wasassessed using adjusted Cox proportional hazards models.
During median follow-up of 6.5 years, 534 (11%) of 4753 AREDS participantsdied. In fully adjusted models, participants with advanced age-related maculardegeneration (AMD) compared with participants with few, if any, drusen hadincreased mortality (relative risk [RR], 1.41; 95% confidence interval [CI],1.08-1.86). Advanced AMD was associated with cardiovascular deaths. Comparedwith participants having good acuity in both eyes, those with visual acuityworse 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 andwith cancer deaths. Participants randomly assigned to receive zinc had lowermortality than those not taking zinc (RR, 0.73; 95% CI, 0.61-0.89).
The decreased survival of AREDS participants with AMD and cataract suggeststhat these conditions may reflect systemic rather than only local processes.The improved survival in individuals randomly assigned to receive zinc requiresfurther study.