Physical Activity, Incidence, and Progression of Age-Related Macular Degeneration: A Multicohort Study

Am J Ophthalmol. 2022 Apr:236:99-106. doi: 10.1016/j.ajo.2021.10.008. Epub 2021 Oct 22.


Purpose: To investigate the impact of physical activity (PA) on the incidence or progression of age-related macular degeneration (AMD) in the general population.

Design: Meta-analysis of longitudinal cohort studies.

Methods: We included 14,630 adults with no or early AMD at baseline from 7 population-based studies and examined associations of PA with AMD incidence and progression using multistate models (MSM) per study and subsequent random effects meta-analysis. Age effects were assessed using meta-regression. The main outcome measure was the hazard ratio (HR) for incident early or progression to late AMD.

Results: At baseline, mean age was 60.7 ± 6.9 to 76.4 ± 4.3 years, and prevalence of early AMD was 7.7% (range, 3.6%-16.9%) between cohorts. During follow-up, 1461 and 189 events occurred for early and late AMD, respectively. In meta-analyses, no or low to moderate PA (high PA as reference) was associated with an increased risk for incident early AMD (HR, 1.19; 95% CI, 1.01-1.40; P = .04), but not for late AMD. In subsequent meta-regression, we found no association of age with the effect of PA on incident AMD.

Conclusions: Our study suggests high levels of PA to be protective for the development of early AMD across several population-based cohort studies. Our results establish PA as a modifiable risk factor for AMD and inform further AMD prevention strategies to reduce its public health impact.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Disease Progression
  • Exercise
  • Follow-Up Studies
  • Humans
  • Incidence
  • Longitudinal Studies
  • Macular Degeneration* / diagnosis
  • Macular Degeneration* / epidemiology
  • Middle Aged
  • Risk Factors