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

Matthias M. Mauschitz*, Marie Therese Schmitz, European Eye Epidemiology (E3) Consortium, 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 GüntherAnnette Peters, Caroline C.W. Klaver, Robert P. Finger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


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.

Original languageEnglish
Pages (from-to)99-106
Number of pages8
JournalAmerican Journal of Ophthalmology
Publication statusPublished - Apr 2022


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