Bonnielin K Swenor1, Jiangxia Wang2, Varshini Varadaraj1, Caterina Rosano3, Kristine Yaffe4,5,6,7, Marilyn Albert8, Eleanor M Simonsick9. 1. Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. 2. Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. 3. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania. 4. Department of Psychiatry, University of California, San Francisco, California. 5. Department of Neurology, University of California, San Francisco, California. 6. Department of Epidemiology and Biostatistics, University of California, San Francisco, California. 7. San Francisco Visual Acuity Medical Center, University of California, San Francisco, California. 8. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland. 9. Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland.
Abstract
BACKGROUND: An association between visual impairment and cognitive outcomes has been documented, but there is limited research examining this relationship using multiple measures of vision. METHODS: Participants included non-demented individuals in Year 3 of the Visual impairment was assessed using visual acuity, contrast sensitivity, and stereo acuity. Cognitive function was defined using the digit symbol test and the Modified Mini-Mental State Examination (3MS). Incident cognitive impairment was defined as a 3MS score <80 or a decline >5 points following Year 3. Linear mixed effects models examined longitudinal associations adjusting for year, age, sex, race, education, smoking, depression, diabetes, study site, as well as interaction terms between the vision parameters and years in study, between baseline age and years in study, and quadratic terms of baseline age and years in study. Discrete Cox regression models examined the risk of incident cognitive impairment. RESULTS: Analyses included 2,444 participants (mean age = 74). Visual acuity, contrast sensitivity, and stereo acuity impairments were not associated with statistically significant changes in annual digit symbol test scores over 7 years of follow-up, as compared to those without these impairments. However, visual acuity, contrast sensitivity, and stereo acuity impairments were associated with greater declines in annual 3MS scores over 9 years. Participants with impaired visual acuity, contrast sensitivity, and stereo acuity had a greater risk of incident cognitive impairment. CONCLUSIONS: Our results suggest that visual acuity, contrast sensitivity, and stereo acuity impairments may be risk factors for cognitive decline.
BACKGROUND: An association between visual impairment and cognitive outcomes has been documented, but there is limited research examining this relationship using multiple measures of vision. METHODS:Participants included non-demented individuals in Year 3 of the Visual impairment was assessed using visual acuity, contrast sensitivity, and stereo acuity. Cognitive function was defined using the digit symbol test and the Modified Mini-Mental State Examination (3MS). Incident cognitive impairment was defined as a 3MS score <80 or a decline >5 points following Year 3. Linear mixed effects models examined longitudinal associations adjusting for year, age, sex, race, education, smoking, depression, diabetes, study site, as well as interaction terms between the vision parameters and years in study, between baseline age and years in study, and quadratic terms of baseline age and years in study. Discrete Cox regression models examined the risk of incident cognitive impairment. RESULTS: Analyses included 2,444 participants (mean age = 74). Visual acuity, contrast sensitivity, and stereo acuity impairments were not associated with statistically significant changes in annual digit symbol test scores over 7 years of follow-up, as compared to those without these impairments. However, visual acuity, contrast sensitivity, and stereo acuity impairments were associated with greater declines in annual 3MS scores over 9 years. Participants with impaired visual acuity, contrast sensitivity, and stereo acuity had a greater risk of incident cognitive impairment. CONCLUSIONS: Our results suggest that visual acuity, contrast sensitivity, and stereo acuity impairments may be risk factors for cognitive decline.
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