• Cataract/Anterior Segment

    Review of: Association between cataract extraction and development of dementia

    Lee C, Gibbons L, Lee A, et al. JAMA Internal Medicine, April 2022

    This study focused on both the associations between dementia and cataract surgery and the associations between dementia and glaucoma surgery.

    Study design

    Researchers conducted a retrospective analysis of data from 3038 participants in the ongoing US-based Adult Changes in Thought (ACT) cohort study who were age ≥65 years with a diagnosis of cataract or glaucoma and normal cognitive function at the time of enrollment. During the study’s biennial visits participants underwent dementia screening until incident dementia was diagnosed.

    Outcomes

    Participants who had received cataract surgery had a significantly reduced risk of dementia (hazard ratio [HR] 0.71) compared with participants who had not received surgery. However, there was no association between glaucoma surgery and decreased risk of dementia (HR 1.08). The only other variable that was protective against dementia was the lack of an APOE ε4 allele.

    Limitations

    Ninety-one percent of study participants identified as White, and so results may not be applicable to a more diverse population. However, similar studies in other racial populations had comparable findings. No data on visual acuity were reported.

    Clinical significance

    Sensory impairment associated with aging has been linked to cognitive decline. Given that we have few options for the treatment of dementia, it is crucial to speak with our patients about the impact of cataract surgery on their total health, not just their vision. Improvements in vision, mobility, and cognitive function are all reasons to pursue cataract surgery, even if some patients may be hesitant to undergo surgery.