What are all known risk factors for AMD? Why did this happen to me?

QUESTION: What are the risk factors of AMD? Why did this happen to me?

This post applies only to AMD. Other forms of macular degeneration have different causes and different risk factors.

Risk Factors

The answer is about risk factors for AMD. Quick answers:

1. There’s no way of knowing why this happened to you, so don’t blame yourself. You didn’t know about the disease, so you didn’t knowingly bring it on yourself.
2. Heredity IS a factor but not the cause, so that if you have a first-degree relative with it (parents, siblings, children), you have a higher risk of developing AMD than someone who does not, but that doesn’t mean you will absolutely develop AMD. We have members who have no family history but have AMD. We have members with a family history who never develop it. As a matter of fact, only 10-15% of those with AMD have a first-degree relative with it. For more about genetics & AMD, go to the Genetic Home Reference.
3. If you have certain risk factors, you can work on them. Look at the ones under ‘what you can control’ below.

DETAILS

We talk frequently about risk factors vs causes of AMD. A risk factor is something that has been associated with a disease. A cause is a biological condition that if you have it, you have the disease. We do not know what causes AMD in any individual which is why we often call AMD ‘idiopathic’ which means “relating to or denoting any disease or condition that arises spontaneously or for which the cause is unknown.”

One reason to do this exercise is to understand what can and what can’t be changed. I can’t help but think of the Serenity Prayer: “God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference.”

What You Cannot Change

A. Age >50; risk goes up as age goes up

B. First degree relative: mother or father, siblings, children with AMD

C. Gene variations on ARM2 and CFH and other specific genes (some related to inflammation); don’t know if not tested

D. Race: Caucasian heritage

E. AMD in one eye (other eye is at higher risk)

F. Female

G. Blue eyes

H. Early menopause as determined by medical diagnosis

I. Light skin

What You Can Work On Changing

J. Smoking, former smoking or exposed to second-hand smoke (less than current smokers)

K. BMI/obesity

L. Uncontrolled high blood pressure (hypertension)

M. Sedentary lifestyle

N. Uncontrolled high total cholesterol

O. Poor nutrition including high fat (especially artificial fats & saturated fats) and sugar intake; low plant-based foods intake

P. Sun exposure: Past (can’t change) and current (can change) sun exposure; maybe blue light exposure (conflicting opinions; no firm evidence); includes living in locations with higher amount of exposure to sunlight

Q. Drug side effects: Aralen/chloroquine, Thorazine/chlorpromazine, Mellaril/thioridazine, Prolixin/fluphenazine, Trilafon/perphenazine, Stelazine/trifluoperazine)

R. Poor dental hygiene

S. Exposure to past (can’t change) or current (can change somewhat) environmental toxins

T. Excessive alcohol use

U. Vitamin and mineral deficiencies or excesses as found through medical testing

V. Type 2 diabetes is associated with a higher risk of AMD. Add this letter after some of you have already responded.

There may be more!


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Sue on Assignment: It’s Not Your Fault!

Hey! How are ya? Like I said, I got sort of intrigued by the Just World fallacy. I figured I would read a bit more. Knowledge is power.

It turns out, according to Wiki, this fallacy has been around pretty much forever with philosophers in 180 CE arguing against it. In the 1960s Melvin Lerner started to study it in social psychology. He was curious how brutal regimes maintain popular support. The Just World fallacy helps these regimes because people feel when other people suffered they deserve to suffer. After all, in a Just World why would good people be punished? Thus, if you can make a group suffer, others will look down on them because they deserve what they got. Yikes.

Lerner did propose belief in a Just World is important for our well-being. It allows us to have some faith in the future. However, what happens when you are the one who is experiencing the suffering? Not only do other people tend to blame you…a la the Just World fallacy…but you blame yourself, too!!

This is why the Psychology Today author suggested ditching the Just World concept. It is also why DBT teaches two of the lessons it does.

The first one is the nonjudgmental stance. Pointing the finger and blaming is ineffective. It does not get the job done. What it does do is produce shame and guilt.

The second lesson is “everything has a cause but it is not necessarily you!” When I teach that concept I get out the list of risk factors for AMD. Above 55 years of age. Female. White. High blood pressure. Family history of AMD. Sun exposure. A diet lacking in some nutrients. I have the whole lot of those. Yes, I missed blue eyes, smoking lack of activity and obesity, but hey, that is 7 out of 11!

It is not a question of why me, but one of why NOT me?

And did you notice most of the ones I hit are things I could do nothing about? I am a 65-year-old, white female who had a father with AMD. So, shoot me. How is this my fault? It’s not. When all is said and done, life is not fair. There is much that is not contingent upon our behaviors. You did not cause your AMD You are not bad.

So that is the Just World fallacy. Recognizing the world is not fair and just and, indeed, bad things happen to good people may not do much to end your coping fatigue but then again, it could do quite a bit. Are you the type who is afraid you are somehow responsible for your vision loss? Do you spend hours and days trying to decide what you did to deserve this? Knowing the Just World assumption is a fallacy can get you away from beating yourself up. It can remove the burden of guilt. You did not do this. Life is not fair. You are off the hook for this one! Feel better now?

Written November 30th, 2018

Next: Sue on Assignment: Exhausted by Life?

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