Chi-Jung Tai1,2, Tzyy-Guey Tseng1, Chih-Jung Yeh3, Wen-Chun Liao4, Yu-Han Hsiao3,5,6, Shu-Hsin Lee7,8, Tsu-Ann Kuo9, Fu-Wen Liang10, Meng-Chih Lee11,12,13,14. 1. Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 2. Department of Family Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan. 3. School of Public Health, Chung Shan Medical University, Taichung, Taiwan. 4. School of Nursing, China Medical University, Taichung, Taiwan. 5. Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan. 6. College of Management, Chaoyang University of Technology, Taichung, Taiwan. 7. School of Nursing, Chung Shan Medical University, Taichung, Taiwan. 8. Center for Education and Research on Geriatrics and Gerontology, Chung Shan Medical University, Taichung, Taiwan. 9. Department of Medical Sociology and Social Work, Chung Shan Medical University, Taichung, Taiwan. 10. Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan. fwliang@kmu.edu.tw. 11. Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan. mengchihlee@gmail.com. 12. College of Management, Chaoyang University of Technology, Taichung, Taiwan. mengchihlee@gmail.com. 13. Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan. mengchihlee@gmail.com. 14. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. mengchihlee@gmail.com.
Abstract
BACKGROUND: Visual impairment (VI) was associated with cognitive impairment. However, different visual trajectories might contribute to different risks of cognitive decline in the elderly. AIMS: This study aimed to evaluate the association between visual trajectories and cognitive impairment. METHODS: Four thousand two hundred eight community-dwelling elder adults were identified from Waves IV-VII (1999-2011) survey of the Taiwan Longitudinal Study on Aging (TLSA). Cognitive function was determined using the Short Portable Mental Status Questionnaire (SPMSQ) scores. Visual impairment was self-reported and visual trajectories were assessed in at least two waves of the survey. Ordinal logistic regression was performed to estimate adjusted odds ratios (adjORs) and 95% confidence intervals (CIs). RESULTS: Participants with visual trajectory from no VI to VI had significantly higher risk of cognitive impairment with an adjOR of 1.69 (95% CI 1.12-2.57) than participants without VI. Compared to participants without VI, participants with persistent VI (adjOR 1.32; 95% CI 0.89-1.96) and with visual trajectory from VI to no VI (adjOR 1.25; 95% CI 0.83-1.88) were not associated with cognitive impairment. A protective association between eyeglasses use and cognitive impairment (adjOR 0.69; 95% CI 0.55-0.87) was found in this study. Importantly, cataract was associated with higher risk of cognitive impairment (adjOR 1.34; 95% CI 1.10-1.62). However, nonsurgical cataract treatment did not show protective effect on cognitive impairment in patients with cataract. CONCLUSIONS AND DISCUSSION: Visual trajectory from no VI to VI is a significant risk factor for cognitive impairment that physicians should pay special attention during community screening.
BACKGROUND: Visual impairment (VI) was associated with cognitive impairment. However, different visual trajectories might contribute to different risks of cognitive decline in the elderly. AIMS: This study aimed to evaluate the association between visual trajectories and cognitive impairment. METHODS: Four thousand two hundred eight community-dwelling elder adults were identified from Waves IV-VII (1999-2011) survey of the Taiwan Longitudinal Study on Aging (TLSA). Cognitive function was determined using the Short Portable Mental Status Questionnaire (SPMSQ) scores. Visual impairment was self-reported and visual trajectories were assessed in at least two waves of the survey. Ordinal logistic regression was performed to estimate adjusted odds ratios (adjORs) and 95% confidence intervals (CIs). RESULTS: Participants with visual trajectory from no VI to VI had significantly higher risk of cognitive impairment with an adjOR of 1.69 (95% CI 1.12-2.57) than participants without VI. Compared to participants without VI, participants with persistent VI (adjOR 1.32; 95% CI 0.89-1.96) and with visual trajectory from VI to no VI (adjOR 1.25; 95% CI 0.83-1.88) were not associated with cognitive impairment. A protective association between eyeglasses use and cognitive impairment (adjOR 0.69; 95% CI 0.55-0.87) was found in this study. Importantly, cataract was associated with higher risk of cognitive impairment (adjOR 1.34; 95% CI 1.10-1.62). However, nonsurgical cataract treatment did not show protective effect on cognitive impairment in patients with cataract. CONCLUSIONS AND DISCUSSION: Visual trajectory from no VI to VI is a significant risk factor for cognitive impairment that physicians should pay special attention during community screening.
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