Tai Anh Vu1, Eva K Fenwick2, Alfred T L Gan3, Ryan E K Man2, Benjamin K J Tan4, Preeti Gupta3, Kam Chun Ho5, Carlos A Reyes-Ortiz6, Stella Trompet7, Jacobijn Gussekloo7, Joan M O'Brien8, Sigrid Mueller-Schotte9, Tien Yin Wong2, Yih Chung Tham3, Ching-Yu Cheng2, Allen T C Lee10, Greta Rait11, Bonnielin K Swenor12, Varshini Varadaraj12, Willa D Brenowitz13, Felipe A Medeiros14, Virginie Naël15, Kaavya Narasimhalu16, Christopher L H Chen17, Ecosse L Lamoureux18. 1. Duke-NUS Medical School, Singapore, Republic of Singapore. 2. Duke-NUS Medical School, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore. 3. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore. 4. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore. 5. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; School of Optometry and Visual Science, University of New South Wales, Sydney, Australia; Injury Division, The George Institute for Global Health, Sydney, Australia. 6. Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Agricultural and Mechanical University, Florida. 7. Leiden University Medical Center, Leiden, The Netherlands. 8. Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania. 9. University Medical Center Utrecht, Utrecht, The Netherlands; University of Applied Sciences Utrecht, Utrecht, The Netherlands. 10. Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. 11. Department of Primary Care and Population Health, University College London, London, United Kingdom. 12. Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. 13. Department of Psychiatry, University of California, San Francisco, California. 14. Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina. 15. Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France. 16. Duke-NUS Medical School, Singapore, Republic of Singapore; National Neuroscience Institute (Singapore General Hospital Campus), Singapore, Republic of Singapore. 17. Memory Aging and Cognition Center, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore. 18. Duke-NUS Medical School, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Department of Ophthalmology, The University of Melbourne, Melbourne, Australia. Electronic address: ecosse.lamoureux@seri.com.sg.
Abstract
TOPIC: Visual impairment (VI) and cognitive impairment (CIM) are prevalent age-related conditions that impose substantial burden on the society. Findings on the hypothesized bidirectional association of VI and CIM remains equivocal. Hence, we conducted a systematic review and meta-analysis to examine this bidirectional relationship. CLINICAL RELEVANCE: Sixty percent risk of CIM has not been well elucidated in the literature. A bidirectional relationship between VI and CIM may support the development of strategies for early detection and management of risk factors for both conditions in older people. METHODS: PubMed, Embase, and Cochrane Central registers were searched systematically for observational studies, published from inception until April 6, 2020, in adults 40 years of age or older reporting objectively measured VI and CIM assessment using clinically validated cognitive screening tests or diagnostic evaluation. Meta-analyses on cross-sectional and longitudinal associations between VI and CIM outcomes (any CIM assessed using screening tests and clinically diagnosed dementia) were examined. Random effect models were used to generate pooled odds ratios (ORs) and 95% confidence intervals (CIs). We also examined study quality, publication bias, and heterogeneity. RESULTS: Forty studies were included (n = 47 913 570). Meta-analyses confirmed that persons with VI were more likely to have CIM, with significantly higher odds of: (1) any CIM (cross-sectional: OR, 2.38 [95% CI, 1.84-3.07]; longitudinal: OR, 1.66 [95% CI, 1.46-1.89]) and (2) clinically diagnosed dementia (cross-sectional: OR, 2.43 [95% CI, 1.48-4.01]; longitudinal: OR, 2.09 [95% CI, 1.37-3.21]) compared with persons without VI. Significant heterogeneity was explained partially by differences in age, sex, and follow-up duration. Also, some evidence suggested that individuals with CIM, relative to cognitively intact persons, were more likely to have VI, with most articles (8/9 [89%]) reporting significantly positive associations; however, meta-analyses on this association could not be conducted because of insufficient data. DISCUSSION: Overall, our work suggests that VI is a risk factor of CIM, although further work is needed to confirm the association of CIM as a risk factor for VI. Strategies for early detection and management of both conditions in older people may minimize individual clinical and public health consequences.
TOPIC: Visual impairment (VI) and cognitive impairment (CIM) are prevalent age-related conditions that impose substantial burden on the society. Findings on the hypothesized bidirectional association of VI and CIM remains equivocal. Hence, we conducted a systematic review and meta-analysis to examine this bidirectional relationship. CLINICAL RELEVANCE: Sixty percent risk of CIM has not been well elucidated in the literature. A bidirectional relationship between VI and CIM may support the development of strategies for early detection and management of risk factors for both conditions in older people. METHODS: PubMed, Embase, and Cochrane Central registers were searched systematically for observational studies, published from inception until April 6, 2020, in adults 40 years of age or older reporting objectively measured VI and CIM assessment using clinically validated cognitive screening tests or diagnostic evaluation. Meta-analyses on cross-sectional and longitudinal associations between VI and CIM outcomes (any CIM assessed using screening tests and clinically diagnosed dementia) were examined. Random effect models were used to generate pooled odds ratios (ORs) and 95% confidence intervals (CIs). We also examined study quality, publication bias, and heterogeneity. RESULTS: Forty studies were included (n = 47 913 570). Meta-analyses confirmed that persons with VI were more likely to have CIM, with significantly higher odds of: (1) any CIM (cross-sectional: OR, 2.38 [95% CI, 1.84-3.07]; longitudinal: OR, 1.66 [95% CI, 1.46-1.89]) and (2) clinically diagnosed dementia (cross-sectional: OR, 2.43 [95% CI, 1.48-4.01]; longitudinal: OR, 2.09 [95% CI, 1.37-3.21]) compared with persons without VI. Significant heterogeneity was explained partially by differences in age, sex, and follow-up duration. Also, some evidence suggested that individuals with CIM, relative to cognitively intact persons, were more likely to have VI, with most articles (8/9 [89%]) reporting significantly positive associations; however, meta-analyses on this association could not be conducted because of insufficient data. DISCUSSION: Overall, our work suggests that VI is a risk factor of CIM, although further work is needed to confirm the association of CIM as a risk factor for VI. Strategies for early detection and management of both conditions in older people may minimize individual clinical and public health consequences.
Authors: Jimmy T Le; Elvira Agrón; Tiarnan D L Keenan; Traci E Clemons; Willa D Brenowitz; Kristine Yaffe; Emily Y Chew Journal: Alzheimers Dement Date: 2021-11-10 Impact factor: 16.655
Authors: Mukharram M Bikbov; Gyulli M Kazakbaeva; Ellina M Rakhimova; Iuliia A Rusakova; Albina A Fakhretdinova; Azaliia M Tuliakova; Songhomitra Panda-Jonas; Natalia I Bolshakova; Kamilia R Safiullina; Ainur V Gizzatov; Ildar P Ponomarev; Dilya F Yakupova; Nail E Baymukhametov; Nikolay A Nikitin; Jost B Jonas Journal: BMJ Open Date: 2022-04-26 Impact factor: 3.006
Authors: Varshini Varadaraj; Beatriz Munoz; Jennifer A Deal; Yang An; Marilyn S Albert; Susan M Resnick; Luigi Ferrucci; Bonnielin K Swenor Journal: JAMA Netw Open Date: 2021-07-01
Authors: Joshua R Ehrlich; Bonnielin K Swenor; Yunshu Zhou; Kenneth M Langa Journal: J Gerontol A Biol Sci Med Sci Date: 2021-11-15 Impact factor: 6.591