Association of soft drusen with risk of all-cause and specific-cause mortality in the National Health and Nutrition Examination Survey, 2005 to 2008

Abstract The aim of this study is to investigate the correlation between soft drusen and the likelihood of mortality from all causes and specific ailments within a representative United States population. This cohort study encompassed 4497 individuals from the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES) cycles, and followed for survival to December 31, 2019. Data on soft drusen were obtained from fundus images. Survey-weighted Cox regression models were utilized to evaluate the hazard of soft drusen incidence and mortality. After a median follow-up of 12.33 (11.33, 12.58) years, 1014 (22.5%) patients died from all causes. Overall, individuals with soft drusen exhibited an increased risk for all-cause mortality (HR 1.41; 95% CI 1.22 to 1.64), cardiovascular disease (CVD)-related death (HR 1.53; 95% CI 1.15 to 2.04), and mortality from other causes (HR 1.48; 95% CI 1.20 to 1.83). Further stratified analysis revealed that the mortality rates were heightened in participants who had distinct soft drusen or both types of soft drusen, as well as those with soft drusen measuring 500 μm or more in diameter. The investigation revealed that soft drusen was linked to all-cause mortality, CVD mortality, and mortality resulting from non-cardiovascular and non-cancerous conditions, indicating that soft drusen may symbolize frailty and aging processes.