• The Influence of Visual Impairment on Cognitive Function

    By Mike Mott
    Selected By: Neil M. Bressler, MD, and Deputy Editors

    Journal Highlights

    JAMA Ophthalmology, September 2018

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    Worsening vision and declining cog­nitive function are common among the elderly. To better understand the relationship between the 2 conditions, Zheng et al. conducted a population-based study of older U.S. adults and found that visual impairment might have a substantially large influence on declining mental abilities.

    For this study, the researchers eval­uated 2,520 adults aged 65 to 84 in 4 rounds across a 4-year period. Outcome measures included visual acuity (VA) via Early Treatment Diabetic Retinopa­thy Study (ETDRS) charts and cogni­tive status via the Mini-Mental State Examination (MMSE).

    Both VA and MMSE scores wors­ened over time. The average biannual decline of VA was 0.022 logMAR, and the average annual decline in VA was 0.011 logMAR—an annual loss of less than 1 letter on the ETDRS acuity chart, or roughly 1 line over 8 years. For the MMSE score, the average biannual decline was −0.59.

    The researchers also looked at the VA and MMSE relationship longitudi­nally and found that the rate of wors­ening VA was associated with the rate of declining MMSE score: For example, VA in the previous rounds of examina­tion were associated with MMSE scores in subsequent rounds, and vice versa. However, the impact of VA on the MMSE scores was larger and stronger than the reverse, demonstrating that vision is likely the driving force in this dynamic relationship.

    This longitudinal association be­tween vision and cognitive function suggests that maintaining good vision could be an important strategy for minimizing age-related cognitive change. (Also see related commentary by Paul J. Foster, PhD, FRCS (Ed), Sharon Y.L. Chua, PhD, and Axel Petzold, MD, PhD, in the same issue.)

    The original article can be found here.