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

March 7, 2026
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AUTHORS

Matthias M Mauschitz, Marie-Therese Schmitz, Timo Verzijden, Matthias Schmid, Eric F Thee, Johanna M Colijn, Cécile Delcourt, Audrey Cougnard-Grégoire, Bénédicte M J Merle, Jean-François Korobelnik, Bamini Gopinath, Paul Mitchell, Hisham Elbaz, Alexander K Schuster, Philipp S Wild, Caroline Brandl, Klaus J Stark, Iris M Heid, Felix Günther, Annette Peters, Caroline C W Klaver, Robert P Finger, European Eye Epidemiology (E3) Consortium

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

ABSTRACT

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.

PMID:34695401 | DOI:10.1016/j.ajo.2021.10.008

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