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Yeo BSY, Ong RYX, Ganasekar P, Tan BKJ, Seow DCC, Tsai ASH. Cataract Surgery and Cognitive Benefits in the Older Person: A Systematic Review and Meta-analysis. Ophthalmology 2024; 131:975-984. [PMID: 38336283 DOI: 10.1016/j.ophtha.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/26/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
TOPIC This systematic review and meta-analysis aims to clarify the association of cataract surgery with cognitive impairment and dementia. CLINICAL RELEVANCE The association between vision impairment and cognitive decline is well-established. However, the cognitive benefits of cataract surgery are less clear. Given the lack of cure for dementia, identifying modifiable risk factors is key in caring for patients with cognitive deficits. METHODS The study was conducted following Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. PubMed, Embase, and Cochrane Library were searched from inception through October 11, 2022, for studies reporting the effect of cataract surgery on cognitive impairment and dementia. We pooled maximally adjusted hazard ratios (HRs) for dichotomous outcomes and ratio of means (RoM) for continuous outcomes using a random-effects model. Heterogeneity was examined using sensitivity and subgroup analyses. The quality of evidence was evaluated using the Newcastle-Ottawa scale, Cochrane risk-of-bias tool for randomized trials, and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines. RESULTS This review included 24 articles comprising 558 276 participants, of which 19 articles were analyzed qualitatively. The bias of studies ranged from low to moderate, and GRADE extended from very low to low. Cataract surgery was associated with a 25% reduced risk of long-term cognitive decline compared with those with uncorrected cataracts (HR, 0.75; 95% confidence interval [CI], 0.72-0.78). This cognitive benefit was seen across various cognitive outcomes and remained robust to sensitivity analyses. Participants who underwent cataract surgery showed a similar risk of long-term cognitive decline as healthy controls without cataracts (HR, 0.84; 95% CI, 0.66-1.06). Additionally, cataract surgery was associated with a 4% improvement in short-term cognitive test scores among participants with normal cognition (RoM, 0.96; 95% CI, 0.94-0.99), but no significant association was observed among participants with preexisting cognitive impairment. DISCUSSION Cataract surgery may be associated with a lower risk of cognitive impairment and dementia, and cataract-associated vision impairment may be a modifiable risk factor for cognitive decline. Physicians should be aware of the cognitive sequelae of cataracts and the possible benefits of surgery. The cognitive benefits of cataract surgery should be investigated further in randomized trials. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Brian Sheng Yep Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Rebecca Yi Xuan Ong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Republic of Singapore
| | - Pooja Ganasekar
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Benjamin Kye Jyn Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Dennis Chuen Chai Seow
- Department of Geriatric Medicine, Singapore General Hospital, Singapore, Republic of Singapore; SingHealth Duke-NUS Centre of Memory and Cognitive Disorders, Singapore, Republic of Singapore
| | - Andrew S H Tsai
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore.
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Li Y, Huang Y, Wei F, Li T, Wang Y. Development and validation of a risk prediction model for motoric cognitive risk syndrome in older adults. Aging Clin Exp Res 2024; 36:143. [PMID: 39002102 PMCID: PMC11246282 DOI: 10.1007/s40520-024-02797-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/22/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE The objective of this study was to develop a risk prediction model for motoric cognitive risk syndrome (MCR) in older adults. METHODS Participants were selected from the 2015 China Health and Retirement Longitudinal Study database and randomly assigned to the training group and the validation group, with proportions of 70% and 30%, respectively. LASSO regression analysis was used to screen the predictors. Then, identified predictors were included in multivariate logistic regression analysis and used to construct model nomogram. The performance of the model was evaluated by area under the receiver operating characteristic (ROC) curve (AUC), calibration curves and decision curve analysis (DCA). RESULTS 528 out of 3962 participants (13.3%) developed MCR. Multivariate logistic regression analysis showed that weakness, chronic pain, limb dysfunction score, visual acuity score and Five-Times-Sit-To-Stand test were predictors of MCR in older adults. Using these factors, a nomogram model was constructed. The AUC values for the training and validation sets of the predictive model were 0.735 (95% CI = 0.708-0.763) and 0.745 (95% CI = 0.705-0.785), respectively. CONCLUSION The nomogram constructed in this study is a useful tool for assessing the risk of MCR in older adults, which can help clinicians identify individuals at high risk.
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Affiliation(s)
- Yaqin Li
- School of Nursing, Jinan University, Guangzhou, Guangdong Province, China
| | - Yuting Huang
- School of Nursing, Jinan University, Guangzhou, Guangdong Province, China
| | - Fangxin Wei
- School of Nursing, Jinan University, Guangzhou, Guangdong Province, China
| | - Tanjian Li
- School of Nursing, Jinan University, Guangzhou, Guangdong Province, China
| | - Yu Wang
- The Community Service Center of Jinan University, The First Affiliated Hospital of Jinan University, Tianhe District, Guangzhou, Guangzhou Province, China.
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Lin D, Zhu Q, Zhang S, Zhou F, Zhao L, Wang Q, Chen W, Chen H, Lin X, Feng H, Zhong Q, Chen J, Lin Z, Li X, Xiao W, Zhou Y, Wang J, Li J, Chen W. Postoperative myopic shift and visual acuity rehabilitation in patients with bilateral congenital cataracts. Front Med (Lausanne) 2024; 11:1406287. [PMID: 38756946 PMCID: PMC11096542 DOI: 10.3389/fmed.2024.1406287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background This study aimed to explore the postoperative myopic shift and its relationship to visual acuity rehabilitation in patients with bilateral congenital cataracts (CCs). Methods Bilateral CC patients who underwent cataract extraction and primary intraocular lens implantations before 6 years old were included and divided into five groups according to surgical ages (<2, 2-3, 3-4, 4-5, and 5-6 years). The postoperative myopic shift rates, spherical equivalents (SEs), and the best corrected visual acuity (BCVA) were measured and analyzed. Results A total of 1,137 refractive measurements from 234 patients were included, with a mean follow-up period of 34 months. The postoperative mean SEs at each follow-up in the five groups were linearly fitted with a mean R2 = 0.93 ± 0.03, which showed a downtrend of SE with age (linear regression). Among patients with a follow-up of 4 years, the mean postoperative myopic shift rate was 0.84, 0.81, 0.68, 0.24, and 0.28 diopters per year (D/y) in the five age groups (from young to old), respectively. The BCVA of those with a surgical age of <2 years at the 4-year visit was 0.26 (LogMAR), and the mean postoperative myopic shift rate was 0.84 D/y. For patients with a surgical age of 2-6 years, a poorer BCVA at the 4-year visit was found in those with higher postoperative myopic shift rates (r = 0.974, p = 0.026, Pearson's correlation test). Conclusion Performing cataract surgery for patients before 2 years old and decreasing the postoperative myopic shift rates for those with a surgical age of 2-6 years may benefit visual acuity rehabilitation.
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Affiliation(s)
- Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Qiaolin Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shuyi Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fengqi Zhou
- Mayo Clinic College of Medicine and Science, Rochester, MN, United States
- Department of Ophthalmology, Mayo Clinic Health System, Eau Claire, WI, United States
| | - Lanqin Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Qiwei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Hui Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoshan Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Huanling Feng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Qiuping Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoyan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wei Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yue Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jinghui Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Wang S, Du Z, Lai C, Seth I, Wang Y, Huang Y, Fang Y, Liao H, Hu Y, Yu H, Zhang X. The association between cataract surgery and mental health in older adults: a review. Int J Surg 2024; 110:2300-2312. [PMID: 38668662 PMCID: PMC11020056 DOI: 10.1097/js9.0000000000001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Although cataract surgery has been proposed as a potentially modifiable protective factor for enhancing emotional well-being in cataract patients, studies examining the relationship between anxiety or depression and cataract surgery have yielded inconsistent findings. This review summarizes existing evidence to establish whether cataract surgery is associated with depression and anxiety in older adults. METHODS A literature search was conducted across PubMed, Medline, Web of Science, and Embase databases. An initial screening by abstracts and titles was performed, followed by a review and assessment of the methodological quality of the relevant full papers, and final inclusion of 44 studies were deemed eligible for inclusion in this review. RESULTS Among 44 included studies, 36 studies (81.8%) were observational studies concerning the association of cataract surgery or cataracts with anxiety or depression, four studies (9.1%) were interventional studies, and four studies (9.1%) were reviews. Cataract surgery notably enhances the mental health of individuals with impaired vision. However, the multifaceted nature of psychological well-being, influenced by various factors, suggests that cataract surgery may not address all aspects comprehensively. Additionally, preoperative anxiety and depression significantly impact cataract surgery outcomes. CONCLUSION Vision impairment in older adults is closely associated with increased symptoms of depression and anxiety. While surgical intervention for cataracts improves these symptoms, it might be less effective for mental disorders with multifactorial causes. Notably, anxiety or depression poses challenges to successful preoperative and intraoperative cataract surgeries.
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Affiliation(s)
- Shan Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Zijing Du
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Chunran Lai
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Ishith Seth
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
| | - Yaxin Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yu Huang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
| | - Ying Fang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Huiyi Liao
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Image Analysis and Application, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences
| | - Xiayin Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
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Sourav S, Kekunnaya R, Bottari D, Shareef I, Pitchaimuthu K, Röder B. Sound suppresses earliest visual cortical processing after sight recovery in congenitally blind humans. Commun Biol 2024; 7:118. [PMID: 38253781 PMCID: PMC10803735 DOI: 10.1038/s42003-023-05749-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
Neuroscientific research has consistently shown more extensive non-visual activity in the visual cortex of congenitally blind humans compared to sighted controls; a phenomenon known as crossmodal plasticity. Whether or not crossmodal activation of the visual cortex retracts if sight can be restored is still unknown. The present study, involving a rare group of sight-recovery individuals who were born pattern vision blind, employed visual event-related potentials to investigate persisting crossmodal modulation of the initial visual cortical processing stages. Here we report that the earliest, stimulus-driven retinotopic visual cortical activity (<100 ms) was suppressed in a spatially specific manner in sight-recovery individuals when concomitant sounds accompanied visual stimulation. In contrast, sounds did not modulate the earliest visual cortical response in two groups of typically sighted controls, nor in a third control group of sight-recovery individuals who had suffered a transient phase of later (rather than congenital) visual impairment. These results provide strong evidence for persisting crossmodal activity in the visual cortex after sight recovery following a period of congenital visual deprivation. Based on the time course of this modulation, we speculate on a role of exuberant crossmodal thalamic input which may arise during a sensitive phase of brain development.
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Affiliation(s)
- Suddha Sourav
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany.
| | - Ramesh Kekunnaya
- Jasti V Ramanamma Children's Eye Care Center, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Davide Bottari
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
- IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Idris Shareef
- Jasti V Ramanamma Children's Eye Care Center, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Kabilan Pitchaimuthu
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
- Jasti V Ramanamma Children's Eye Care Center, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | - Brigitte Röder
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
- Jasti V Ramanamma Children's Eye Care Center, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India
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Yoshida Y, Ono K, Sekimoto S, Umeya R, Hiratsuka Y. Impact of cataract surgery on cognitive impairment in older people. Acta Ophthalmol 2023. [PMID: 38146059 DOI: 10.1111/aos.16607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/01/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES To examine the impact of cataract surgery on mild cognitive impairment (MCI) and dementia in older people. METHODS This prospective observational study included patients aged 75 years and older who underwent cataract surgery between 2019 and 2021. Mini-mental state examination (MMSE) and MMSE for the visually impaired (MMSE-blind) were measured to evaluate cognitive function before and 3 months after cataract surgery. MMSE score at baseline was used to categorize patients into dementia (MMSE ≤ 23) and MCI groups (23 < MMSE ≤ 27). Logistic regression models were used to estimate associations between improvement in cognitive function and other factors. RESULTS Of 132 patients screened for inclusion in the study, 88 met the inclusion criteria; 39 patients were assigned to the dementia group (mean age, 85.7 ± 4.2 years) and 49 to the MCI group (mean age, 84.2 ± 3.4 years). The MCI group showed significant improvement from before to after surgery in the MMSE score (25.65 ± 1.03 vs. 27.08 ± 1.99, respectively, p < 0.001) and MMSE-blind score (18.04 ± 1.14 vs. 19.41 ± 2.01, respectively, p < 0.001). Cognitive function improved significantly in the MCI group compared with the dementia group (odds ratio, 2.85; 95% confidence interval, 1.02-7.97; and p = 0.046). CONCLUSIONS Cataract surgery significantly increases cognitive test scores in older patients with MCI. After cataract surgery, the likelihood of improvement in cognitive function may be highly dependent on a patient's preoperative cognitive state.
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Affiliation(s)
- Yuto Yoshida
- Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Koichi Ono
- Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | | | - Reiko Umeya
- Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Yoshimune Hiratsuka
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan
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7
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Li R, Chen W, Li M, Wang R, Zhao L, Lin Y, Chen X, Shang Y, Tu X, Lin D, Wu X, Lin Z, Xu A, Wang X, Wang D, Zhang X, Dongye M, Huang Y, Chen C, Zhu Y, Liu C, Hu Y, Zhao L, Ouyang H, Li M, Li X, Lin H. LensAge index as a deep learning-based biological age for self-monitoring the risks of age-related diseases and mortality. Nat Commun 2023; 14:7126. [PMID: 37932255 PMCID: PMC10628111 DOI: 10.1038/s41467-023-42934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/25/2023] [Indexed: 11/08/2023] Open
Abstract
Age is closely related to human health and disease risks. However, chronologically defined age often disagrees with biological age, primarily due to genetic and environmental variables. Identifying effective indicators for biological age in clinical practice and self-monitoring is important but currently lacking. The human lens accumulates age-related changes that are amenable to rapid and objective assessment. Here, using lens photographs from 20 to 96-year-olds, we develop LensAge to reflect lens aging via deep learning. LensAge is closely correlated with chronological age of relatively healthy individuals (R2 > 0.80, mean absolute errors of 4.25 to 4.82 years). Among the general population, we calculate the LensAge index by contrasting LensAge and chronological age to reflect the aging rate relative to peers. The LensAge index effectively reveals the risks of age-related eye and systemic disease occurrence, as well as all-cause mortality. It outperforms chronological age in reflecting age-related disease risks (p < 0.001). More importantly, our models can conveniently work based on smartphone photographs, suggesting suitability for routine self-examination of aging status. Overall, our study demonstrates that the LensAge index may serve as an ideal quantitative indicator for clinically assessing and self-monitoring biological age in humans.
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Affiliation(s)
- Ruiyang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wenben Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Mingyuan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ruixin Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Lanqin Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yuanfan Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xinwei Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yuanjun Shang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xueer Tu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zhenzhe Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Andi Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xun Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Dongni Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xulin Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Meimei Dongye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yunjian Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Chuan Chen
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yi Zhu
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Chunqiao Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Youjin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ling Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Hong Ouyang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Miaoxin Li
- Center for Precision Medicine and Department of Genetics and Biomedical Informatics, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Sun Yat-sen University, Guangzhou, China
| | - Xuri Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
- Center for Precision Medicine and Department of Genetics and Biomedical Informatics, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, China.
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8
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Mencucci R, Stefanini S, Favuzza E, Cennamo M, De Vitto C, Mossello E. Beyond vision:Cataract and health status in old age, a narrative review. Front Med (Lausanne) 2023; 10:1110383. [PMID: 37007780 PMCID: PMC10061098 DOI: 10.3389/fmed.2023.1110383] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
Cataract is a leading cause of visual impairment in old age. Lens opacification is notoriously associated with several geriatric conditions, including frailty, fall risk, depression and cognitive impairment. The association is largely attributable to visual impairment, while other mechanisms, associated with extraocular comorbidity and lifestyle, might partly explain this correlation. Available literature suggests that cataract surgery may be effective in decreasing fall risk, improving depressive symptoms and limiting the risk of cognitive impairment and dementia incidence, although intervention studies on these outcomes are still limited. In this review we also emphasize the need to move from the concept of visual acuity to functional vision, especially in the context of the geriatric patient. Research is needed regarding the effect on the cited outcomes of different cataract treatment strategies, such as systematic bilateral versus monolateral surgery and use of different intraocular lenses.
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Affiliation(s)
- Rita Mencucci
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- *Correspondence: Rita Mencucci,
| | - Simone Stefanini
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Eleonora Favuzza
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Michela Cennamo
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Chiara De Vitto
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Enrico Mossello
- Division of Geriatric and Intensive Care Medicine, Azienda Ospedaliero Universitaria Careggi, and Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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9
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Das S, Mehregan C, Richards C, Schneider M, Le K, Lin X. Intraoperative Complication Rates in Cataract Surgery After Resuming Surgery Following the COVID-19 Shutdown. Clin Ophthalmol 2023; 17:641-647. [PMID: 36861034 PMCID: PMC9969798 DOI: 10.2147/opth.s348710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 11/15/2022] [Indexed: 02/25/2023] Open
Abstract
Purpose To evaluate surgeon performance and intraoperative complication rates of cataract surgery after resumption of elective surgeries following the operating room (OR) shutdown from the coronavirus disease 2019 (COVID-19) pandemic. Subjective surgical experience is also evaluated. Methods This is a retrospective comparative study which analyzes cataract surgeries performed at an inner city, tertiary academic center. Cataract surgeries were categorized into Pre-Shutdown (January 1-March 18, 2020), and Post-Shutdown, for all cases which occurred after surgeries resumed (May 11-July 31, 2020). No cases were performed between March 19 and May 10, 2020. Patients undergoing combined cataract and minimally invasive glaucoma surgery (MIGS) were included, but MIGS complications were not counted as cataract complications. No other combined cataract-other ophthalmic surgeries were included. A survey was used to gather subjective surgeon experience. Results A total of 480 cases (n=306 Pre-Shutdown and n=174 Post-Shutdown) were analyzed. Although there was a higher frequency of complex cataract surgeries performed Post-Shutdown (5.2% vs 21.3%; p<0.00001), complication rates before versus after the shutdown were not statistically significant (9.2% vs 10.3%; p=0.75). Phacoemulsification was the step of cataract surgery in which residents were most concerned about when returning to the OR. Conclusion After the surgical hiatus due to COVID-19, significantly more complex cataract surgeries were reported and surgeons reported higher general anxiety level when first returning to the OR. Increased anxiety did not lead to higher surgical complications. This study provides a framework to understand surgical expectations and outcomes for patients whose surgeons faced a prolonged two-month hiatus from cataract surgery.
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Affiliation(s)
- Shibandri Das
- Kresge Eye Institute Department of Ophthalmology, Visual and Anatomic Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Christian Mehregan
- Kresge Eye Institute Department of Ophthalmology, Visual and Anatomic Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | | | - Michael Schneider
- Kresge Eye Institute Department of Ophthalmology, Visual and Anatomic Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Kim Le
- Department of Ophthalmology, Henry Ford Hospital, Detroit, MI, USA
| | - Xihui Lin
- Kresge Eye Institute Department of Ophthalmology, Visual and Anatomic Sciences, Wayne State University School of Medicine, Detroit, MI, USA,Correspondence: Xihui Lin, Kresge Eye Institute, Department of Ophthalmology, Visual and Anatomic Sciences, Wayne State University School of Medicine, Detroit, MI, USA, Tel +1 314-359-2691, Fax +1 313 577-9675, Email
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10
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Abraham AG, Hong C, Deal JA, Bettcher BM, Pelak VS, Gross A, Jiang K, Swenor B, Wittich W. Are cognitive researchers ignoring their senses? The problem of sensory deficit in cognitive aging research. J Am Geriatr Soc 2023; 71:1369-1377. [PMID: 36680402 DOI: 10.1111/jgs.18229] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/12/2022] [Accepted: 12/23/2022] [Indexed: 01/22/2023]
Abstract
Sensory impairments are common in older adult populations and have notable impacts on aging outcomes. Relationships between sensory and cognitive functions have been clearly established, though the mechanisms underlying those relationships are not fully understood. Given the growing burden of dementia, older adults with sensory deficits are an important and growing population to study in cognitive aging research. Yet, cognitive research sometimes excludes those with uncorrected significant/severe sensory deficits and often poorly or inconsistently assesses those deficits. Observational and interventional studies that exclude participants with sensory deficits will be limited in their generalizability to the narrower subset of the older adult population without vision or hearing impairment and may be missing an opportunity to study a growing population of older adults at higher risk of cognitive impairment. Strategies exist for adapting cognitive testing instruments, and inroads could be made into collecting normative data to inform ongoing research. Bringing together psychometricians with researchers who specialize in vision and hearing impairments could launch highly innovative research on both measurement methods and cognitive disease etiology, as sensory organs provide readily accessible neuronal and vascular beds that may show pathology earlier and elucidate innovative screening opportunities for early signs of cognitive disease.
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Affiliation(s)
- Alison G Abraham
- University of Colorado, Colorado School of Public Health, Department of Epidemiology, Aurora, Colorado, USA.,Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA.,Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Chris Hong
- Johns Hopkins Zanvyl Krieger School of Arts and Sciences, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA
| | - Brianne M Bettcher
- Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Victoria S Pelak
- Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alden Gross
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA
| | - Kening Jiang
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA
| | | | - Walter Wittich
- École d'optométrie, Université de Montréal, Montreal, Canada
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11
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Ashtari M, Lipin M, Duong M, Ying GS, Yu Y, Maguire A, Bennett J. Neuroplasticity of the Lateral Geniculate Nucleus in Response to Retinal Gene Therapy in a Group of Patients with RPE65 Mutations. Eye Brain 2022; 14:137-147. [PMID: 36531433 PMCID: PMC9749418 DOI: 10.2147/eb.s377275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Previous works on experience-dependent brain plasticity have been limited to the cortical structures, overlooking subcortical visual structures such as the lateral geniculate nucleus (LGN). Animal studies have shown substantial experience dependent plasticity and using fMRI, human studies have demonstrated similar properties in patients with cataract surgery. However, in neither animal nor human studies LGN has not been directly assessed, mainly due to its small size, tissue heterogeneity, low contrast/noise ratio, and low spatial resolution. Methods Utilizing a new algorithm that markedly improves the LGN visibility, LGN was evaluated in a group of low vision patients before and after retinal intervention to reinstate vision and normal sighted matched controls. Results Between and within groups comparisons showed that patients had significantly smaller left (p< 0.0001) and right (p < 0.00002) LGN volumes at baseline as compared to the one-year follow-up volumes. The same baseline and one year comparison in controls was not significant. Significant positive correlations were observed between the incremental volume increase after gene therapy of the left LGN and the incremental increase in the right (r = 0.71, p < 0.02) and left (r = 0.72, p = 0.018) visual fields. Incremental volume increase of the right LGN also showed a similar positive slope but did not reach significance. Discussion These results show that despite significantly less volume at baseline, retinal gene therapy promotes robust expansion and increase in LGN volume. Reinstating vision may have facilitated the establishment of new connections between the retina and the LGN and/or unmasking of the dormant connections. The exact trajectory of the structural changes taking place in LGN is unclear but our data shows that even after years of low vision, the LGN in RPE65 patients has the potential for plasticity and expansion to a nearly normal volume one year after gene therapy administration.
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12
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Koo B, Weiland JD. Progressive Retinal Degeneration Increases Cortical Response Latency of Light Stimulation but Not of Electric Stimulation. Transl Vis Sci Technol 2022; 11:19. [PMID: 35446408 PMCID: PMC9034728 DOI: 10.1167/tvst.11.4.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/31/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose The brain is known to change functionally and structurally in response to blindness, but less is known about the effects of restoration of cortical input on brain function. Here, we present a preliminary study to observe alterations in visual and electrical evoked cortical potentials as a function of age in a clinically relevant animal model of retinitis pigmentosa. Methods We recorded brain potentials elicited by light (visual evoked potentials [VEPs]) or corneal electrical stimulation (electrical evoked response [EER]) in retinal degenerate animal model LE-P23H-1. We used a linear mixed model to examine the effects of age on latency and amplitude of VEP and EER age groups P120, P180, and P360. Results VEP N1, P1, and N2 latency and amplitude were analyzed across animal age. For 1 Hz VEP, N1 latency increased significantly with animal age (slope = 0.053 ± 0.020 ms/day, P < 0.01). For 10 Hz VEP, N1, P1, and N2 latency increased significantly with animal age (slope = 0.104 ± 0.011, 0.135 ± 0.011, 0.087 ± 0.023 ms/day, and P < 0.001 for all VEP peaks). Conversely, EER latency did not change with age. Signal amplitude of VEP or EER did not change with age. Conclusions Cortical potentials evoked by electrical stimulation of the retina do not diminish in spite of continued retinal degeneration in P23H rats. Translational Relevance These findings suggest that retinal bioelectronic treatments of retinitis pigmentosa will activate cortex consistently despite variations in outer retinal degeneration. Clinical studies of retinal stimulation should consider varying retinitis pigmentosa genotypes as part of the experimental design.
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Affiliation(s)
- Beomseo Koo
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - James D. Weiland
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
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13
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Nichols E, Deal JA, Swenor BK, Abraham AG, Armstrong NM, Carlson MC, Griswold M, Lin FR, Mosley TH, Ramulu PY, Reed NS, Resnick SM, Sharrett AR, Gross AL. Assessing Bias in Cognitive Testing for Older Adults with Sensory Impairment: An Analysis of Differential Item Functioning in the Baltimore Longitudinal Study on Aging (BLSA) and the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS). J Int Neuropsychol Soc 2022; 28:154-165. [PMID: 33896441 PMCID: PMC8546003 DOI: 10.1017/s1355617721000400] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Vision and hearing impairments affect 55% of people aged 60+ years and are associated with lower cognitive test performance; however, tests rely on vision, hearing, or both. We hypothesized that scores on tests that depend on vision or hearing are different among those with vision or hearing impairments, respectively, controlling for underlying cognition. METHODS Leveraging cross-sectional data from the Baltimore Longitudinal Study of Aging (BLSA) and the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), we used item response theory to test for differential item functioning (DIF) by vision impairment (better eye presenting visual acuity worse than 20/40) and hearing impairment (better ear .5-4 kHz pure-tone average > 25 decibels). RESULTS We identified DIF by vision impairment for tests whose administrations do not rely on vision [e.g., Delayed Word Recall both in ARIC-NCS: .50 logit difference between impaired and unimpaired (p = .04) and in BLSA: .62 logits (p = .02)] and DIF by hearing impairment for tests whose administrations do not rely on hearing [Digit Symbol Substitution test in BLSA: 1.25 logits (p = .001) and Incidental Learning test in ARIC-NCS: .35 logits (p = .001)]. However, no individuals had differences between unadjusted and DIF-adjusted measures of greater than the standard error of measurement. CONCLUSIONS DIF by sensory impairment in cognitive tests was independent of administration characteristics, which could indicate that elevated cognitive load among persons with sensory impairment plays a larger role in test performance than previously acknowledged. While these results were unexpected, neither of these samples are nationally representative and each has unique selection factors; thus, replication is critical.
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Affiliation(s)
- E Nichols
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
| | - J A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD21205, USA
| | - B K Swenor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
- Wilmer Eye Institute, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD21287, USA
| | - A G Abraham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
- Department of Epidemiology, School of Public Health, University of Colorado Anschutz Medical Campus, 1635 Aurora Ct, Aurora, CO 80045, USA
| | - N M Armstrong
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, 700 Butler Dr, Box G-BH, Providence, RI02906, USA
| | - M C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway St, 8th Floor, Baltimore, MD21205, USA
| | - M Griswold
- Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, 2500 North State St, Jackson, MS39216, USA
| | - F R Lin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD21205, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway St, 8th Floor, Baltimore, MD21205, USA
| | - T H Mosley
- Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, 2500 North State St, Jackson, MS39216, USA
| | - P Y Ramulu
- Wilmer Eye Institute, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD21287, USA
| | - N S Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD21205, USA
| | - S M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, 251 Bayview Blvd, Suite 101, Baltimore, MD21224, USA
| | - A R Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
| | - A L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
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14
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Lee CS, Gibbons LE, Lee AY, Yanagihara RT, Blazes MS, Lee ML, McCurry SM, Bowen JD, McCormick WC, Crane PK, Larson EB. Association Between Cataract Extraction and Development of Dementia. JAMA Intern Med 2022; 182:134-141. [PMID: 34870676 PMCID: PMC8649913 DOI: 10.1001/jamainternmed.2021.6990] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
IMPORTANCE Visual function is important for older adults. Interventions to preserve vision, such as cataract extraction, may modify dementia risk. OBJECTIVE To determine whether cataract extraction is associated with reduced risk of dementia among older adults. DESIGN, SETTING, AND PARTICIPANTS This prospective, longitudinal cohort study analyzed data from the Adult Changes in Thought study, an ongoing, population-based cohort of randomly selected, cognitively normal members of Kaiser Permanente Washington. Study participants were 65 years of age or older and dementia free at enrollment and were followed up biennially until incident dementia (all-cause, Alzheimer disease, or Alzheimer disease and related dementia). Only participants who had a diagnosis of cataract or glaucoma before enrollment or during follow-up were included in the analyses (ie, a total of 3038 participants). Data used in the analyses were collected from 1994 through September 30, 2018, and all data were analyzed from April 6, 2019, to September 15, 2021. EXPOSURES The primary exposure of interest was cataract extraction. Data on diagnosis of cataract or glaucoma and exposure to surgery were extracted from electronic medical records. Extensive lists of dementia-related risk factors and health-related variables were obtained from study visit data and electronic medical records. MAIN OUTCOMES AND MEASURES The primary outcome was dementia as defined by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Multivariate Cox proportional hazards regression analyses were conducted with the primary outcome. To address potential healthy patient bias, weighted marginal structural models incorporating the probability of surgery were used and the association of dementia with glaucoma surgery, which does not restore vision, was evaluated. RESULTS In total, 3038 participants were included (mean [SD] age at first cataract diagnosis, 74.4 (6.2) years; 1800 women (59%) and 1238 men (41%); and 2752 (91%) self-reported White race). Based on 23 554 person-years of follow-up, cataract extraction was associated with significantly reduced risk (hazard ratio, 0.71; 95% CI, 0.62-0.83; P < .001) of dementia compared with participants without surgery after controlling for years of education, self-reported White race, and smoking history and stratifying by apolipoprotein E genotype, sex, and age group at cataract diagnosis. Similar results were obtained in marginal structural models after adjusting for an extensive list of potential confounders. Glaucoma surgery did not have a significant association with dementia risk (hazard ratio, 1.08; 95% CI, 0.75-1.56; P = .68). Similar results were found with the development of Alzheimer disease dementia. CONCLUSIONS AND RELEVANCE This cohort study found that cataract extraction was significantly associated with lower risk of dementia development. If validated in future studies, cataract surgery may have clinical relevance in older adults at risk of developing dementia.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle.,Roger and Angie Karalis Johnson Retina Center, Seattle, Washington
| | - Laura E Gibbons
- Department of General Internal Medicine, University of Washington, Seattle
| | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle.,Roger and Angie Karalis Johnson Retina Center, Seattle, Washington
| | | | - Marian S Blazes
- Department of Ophthalmology, University of Washington, Seattle
| | - Michael L Lee
- Department of General Internal Medicine, University of Washington, Seattle
| | | | - James D Bowen
- Department of Neurology, Swedish Medical Center, Seattle, Washington
| | - Wayne C McCormick
- Department of General Internal Medicine, University of Washington, Seattle
| | - Paul K Crane
- Department of General Internal Medicine, University of Washington, Seattle
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
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15
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Sobczak AM, Bohaterewicz B, Fafrowicz M, Domagalik A, Beldzik E, Oginska H, Golonka N, Rekas M, Bronicki D, Romanowska-Dixon B, Bolsega-Pacud J, Karwowski W, Farahani FV, Marek T. The Influence of Intraocular Lens Implantation and Alterations in Blue Light Transmittance Level on the Brain Functional Network Architecture Reorganization in Cataract Patients. Brain Sci 2021; 11:brainsci11111400. [PMID: 34827400 PMCID: PMC8615544 DOI: 10.3390/brainsci11111400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/16/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cataract is one of the most common age-related vision deteriorations, leading to opacification of the lens and therefore visual impairment as well as blindness. Both cataract extraction and the implantation of blue light filtering lens are believed to improve not only vision but also overall functioning. METHODS Thirty-four cataract patients were subject to resting-state functional magnetic resonance imaging before and after cataract extraction and intraocular lens implantation (IOL). Global and local graph metrics were calculated in order to investigate the reorganization of functional network architecture associated with alterations in blue light transmittance. Psychomotor vigilance task (PVT) was conducted. RESULTS Graph theory-based analysis revealed decreased eigenvector centrality after the cataract extraction and IOL replacement in inferior occipital gyrus, superior parietal gyrus and many cerebellum regions as well as increased clustering coefficient in superior and inferior parietal gyrus, middle temporal gyrus and various cerebellum regions. PVT results revealed significant change between experimental sessions as patients responded faster after IOL replacement. Moreover, a few regions were correlated with the difference in blue light transmittance and the time reaction in PVT. CONCLUSION Current study revealed substantial functional network architecture reorganization associated with cataract extraction and alteration in blue light transmittance.
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Affiliation(s)
- Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (E.B.); (H.O.); (N.G.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
- Correspondence: (A.M.S.); (B.B.)
| | - Bartosz Bohaterewicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (E.B.); (H.O.); (N.G.); (T.M.)
- Department of Psychology of Individual Differences, Psychological Diagnosis, and Psychometrics, Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland
- Correspondence: (A.M.S.); (B.B.)
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (E.B.); (H.O.); (N.G.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Aleksandra Domagalik
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Ewa Beldzik
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (E.B.); (H.O.); (N.G.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Halszka Oginska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (E.B.); (H.O.); (N.G.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Natalia Golonka
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (E.B.); (H.O.); (N.G.); (T.M.)
| | - Marek Rekas
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Dominik Bronicki
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Bożena Romanowska-Dixon
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Joanna Bolsega-Pacud
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Waldemar Karwowski
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.V.F.)
| | - Farzad V. Farahani
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.V.F.)
- Biostatistics Department, John Hopkins University, Baltimore, MD 21218, USA
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (E.B.); (H.O.); (N.G.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
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16
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Lowndes R, Molz B, Warriner L, Herbik A, de Best PB, Raz N, Gouws A, Ahmadi K, McLean RJ, Gottlob I, Kohl S, Choritz L, Maguire J, Kanowski M, Käsmann-Kellner B, Wieland I, Banin E, Levin N, Hoffmann MB, Morland AB, Baseler HA. Structural Differences Across Multiple Visual Cortical Regions in the Absence of Cone Function in Congenital Achromatopsia. Front Neurosci 2021; 15:718958. [PMID: 34720857 PMCID: PMC8551799 DOI: 10.3389/fnins.2021.718958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
Most individuals with congenital achromatopsia (ACHM) carry mutations that affect the retinal phototransduction pathway of cone photoreceptors, fundamental to both high acuity vision and colour perception. As the central fovea is occupied solely by cones, achromats have an absence of retinal input to the visual cortex and a small central area of blindness. Additionally, those with complete ACHM have no colour perception, and colour processing regions of the ventral cortex also lack typical chromatic signals from the cones. This study examined the cortical morphology (grey matter volume, cortical thickness, and cortical surface area) of multiple visual cortical regions in ACHM (n = 15) compared to normally sighted controls (n = 42) to determine the cortical changes that are associated with the retinal characteristics of ACHM. Surface-based morphometry was applied to T1-weighted MRI in atlas-defined early, ventral and dorsal visual regions of interest. Reduced grey matter volume in V1, V2, V3, and V4 was found in ACHM compared to controls, driven by a reduction in cortical surface area as there was no significant reduction in cortical thickness. Cortical surface area (but not thickness) was reduced in a wide range of areas (V1, V2, V3, TO1, V4, and LO1). Reduction in early visual areas with large foveal representations (V1, V2, and V3) suggests that the lack of foveal input to the visual cortex was a major driving factor in morphological changes in ACHM. However, the significant reduction in ventral area V4 coupled with the lack of difference in dorsal areas V3a and V3b suggest that deprivation of chromatic signals to visual cortex in ACHM may also contribute to changes in cortical morphology. This research shows that the congenital lack of cone input to the visual cortex can lead to widespread structural changes across multiple visual areas.
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Affiliation(s)
- Rebecca Lowndes
- Department of Psychology, University of York, York, United Kingdom
- York Neuroimaging Centre, Department of Psychology, University of York, York, United Kingdom
| | - Barbara Molz
- Department of Psychology, University of York, York, United Kingdom
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Lucy Warriner
- Department of Psychology, University of York, York, United Kingdom
| | - Anne Herbik
- Department of Ophthalmology, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - Pieter B. de Best
- MRI Unit, Department of Neurology, Hadassah Medical Center, Jerusalem, Israel
| | - Noa Raz
- MRI Unit, Department of Neurology, Hadassah Medical Center, Jerusalem, Israel
| | - Andre Gouws
- York Neuroimaging Centre, Department of Psychology, University of York, York, United Kingdom
| | - Khazar Ahmadi
- Department of Ophthalmology, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - Rebecca J. McLean
- University of Leicester Ulverscroft Eye Unit, University of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Irene Gottlob
- University of Leicester Ulverscroft Eye Unit, University of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Susanne Kohl
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, Centre for Ophthalmology, University Clinics Tübingen, Tübingen, Germany
| | - Lars Choritz
- Department of Ophthalmology, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - John Maguire
- School of Optometry and Vision Sciences, University of Bradford, Bradford, United Kingdom
| | - Martin Kanowski
- Department of Neurology, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - Barbara Käsmann-Kellner
- Department of Ophthalmology, Saarland University Hospital and Medical Faculty of the Saarland University Hospital, Homburg, Germany
| | - Ilse Wieland
- Department of Molecular Genetics, Institute for Human Genetics, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - Eyal Banin
- Degenerative Diseases of the Retina Unit, Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Netta Levin
- MRI Unit, Department of Neurology, Hadassah Medical Center, Jerusalem, Israel
| | - Michael B. Hoffmann
- Department of Ophthalmology, University Hospital, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Antony B. Morland
- Department of Psychology, University of York, York, United Kingdom
- York Biomedical Research Institute, University of York, York, United Kingdom
| | - Heidi A. Baseler
- Department of Psychology, University of York, York, United Kingdom
- York Biomedical Research Institute, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
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Sobczak AM, Bohaterewicz B, Fafrowicz M, Zyrkowska A, Golonka N, Domagalik A, Beldzik E, Oginska H, Rekas M, Bronicki D, Romanowska-Dixon B, Bolsega-Pacud J, Karwowski W, Farahani F, Marek T. Brain Functional Network Architecture Reorganization and Alterations of Positive and Negative Affect, Experiencing Pleasure and Daytime Sleepiness in Cataract Patients after Intraocular Lenses Implantation. Brain Sci 2021; 11:brainsci11101275. [PMID: 34679340 PMCID: PMC8533692 DOI: 10.3390/brainsci11101275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Cataracts are associated with progressive blindness, and despite the decline in prevalence in recent years, it remains a major global health problem. Cataract extraction is reported to influence not only perception, attention and memory but also daytime sleepiness, ability to experience pleasure and positive and negative affect. However, when it comes to the latter, the magnitude and prevalence of this effect still remains uncertain. The current study aims to evaluate the hemodynamic basis of daytime sleepiness, ability to experience pleasure and positive and negative affect in cataract patients after the intraocular lens (IOL) implantation. Methods: Thirty-four cataract patients underwent resting-state functional magnetic resonance imaging evaluation before and after cataract extraction and intraocular lens implantation. Both global and local graph metrics were calculated in order to investigate the hemodynamic basis of excessive sleepiness (ESS), experiencing pleasure (SHAPS) as well as positive and negative affect (PANAS) in cataract patients. Results: Eigenvector centrality and clustering coefficient alterations associated with cataract extraction are significantly correlated with excessive sleepiness, experiencing pleasure as well as positive and negative affect. Conclusions: The current study reveals the hemodynamic basis of sleepiness, pleasure and affect in patients after cataract extraction and intraocular lens implantation. The aforementioned mechanism constitutes a proof for changes in functional network activity associated with postoperative vision improvement.
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Affiliation(s)
- Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
- Correspondence: (A.M.S.); (B.B.)
| | - Bartosz Bohaterewicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Department of Psychology of Individual Differences, Psychological Diagnosis, and Psychometrics, Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland
- Correspondence: (A.M.S.); (B.B.)
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Aleksandra Zyrkowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
| | - Natalia Golonka
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
| | - Aleksandra Domagalik
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Ewa Beldzik
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Halszka Oginska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Marek Rekas
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Dominik Bronicki
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Bozena Romanowska-Dixon
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Joanna Bolsega-Pacud
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Waldemar Karwowski
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.F.)
| | - Farzad Farahani
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.F.)
- Biostatistics Department, John Hopkins University, Baltimore, MD 21218, USA
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
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Cui T, Yun D, Wu X, Lin H. Anterior Segment and Others in Teleophthalmology: Past, Present, and Future. Asia Pac J Ophthalmol (Phila) 2021; 10:234-243. [PMID: 34224468 DOI: 10.1097/apo.0000000000000396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
ABSTRACT Teleophthalmology, a subfield of telemedicine, has recently been widely applied in ophthalmic disease management, accelerated by ubiquitous connectivity via mobile computing and communication applications. Teleophthalmology has strengths in overcoming geographic barriers and broadening access to medical resources, as a supplement to face-to-face clinical settings. Eyes, especially the anterior segment, are one of the most researched superficial parts of the human body. Therefore, ophthalmic images, easily captured by portable devices, have been widely applied in teleophthalmology, boosted by advancements in software and hardware in recent years. This review aims to revise current teleophthalmology applications in the anterior segment and other diseases from a temporal and spatial perspective, and summarize common scenarios in teleophthalmology, including screening, diagnosis, treatment, monitoring, postoperative follow-up, and tele-education of patients and clinical practitioners. Further, challenges in the current application of teleophthalmology and the future development of teleophthalmology are discussed.
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Affiliation(s)
- Tingxin Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Dongyuan Yun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Center for Precision Medicine, Sun Yat-sen University, Guangzhou, China
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
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19
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Zhang L, Lin D, Wang Y, Chen W, Xiao W, Xiang Y, Zhu Y, Chen C, Dong X, Liu Y, Chen W, Lin H. Comparison of Visual Neuroadaptations After Multifocal and Monofocal Intraocular Lens Implantation. Front Neurosci 2021; 15:648863. [PMID: 34194292 PMCID: PMC8236945 DOI: 10.3389/fnins.2021.648863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/20/2021] [Indexed: 11/24/2022] Open
Abstract
Visual neuroadaptation is believed to play an important role in determining the final visual outcomes following intraocular lens (IOL) implantation. To investigate visual neuroadaptation in patients with age-related cataracts (ARCs) after phacoemulsification with multifocal and monofocal IOL implantation, we conducted a prospective, controlled clinical trial in Zhongshan Ophthalmology Center. This study included 22 patients with bilateral ARCs: 11 patients underwent phacoemulsification and multifocal IOL (Mu-IOL) implantation, and 11 patients underwent phacoemulsification and monofocal IOL (Mo-IOL) implantation. Visual disturbances (glare and halos), visual function (including visual acuity, retinal straylight, contrast sensitivity, and visual evoked potentials) and visual cortical function (fractional amplitude of low-frequency fluctuations, fALFF) in Bowman’s areas 17–19 as the region of interest were assessed before and after surgeries. The results showed that the fALFF values of the visual cortex in the Mu-IOL group decreased at 1 week postoperatively and recovered to baseline at 3 months and then improved at 6 months, compared with preoperative levels (at a whole-brain threshold of P < 0.05, AlphaSim-corrected, voxels > 228, repeated measures analysis of variance). Significantly increased fALFF values in the visual cortex were detected 1 week after surgery in the Mo-IOL group and decreased to baseline at 3 and 6 months. The fALFF of the lingual gyrus was negatively correlated with visual disturbances (P < 0.05). To conclude, early postoperative visual neuroadaptation was detected in the Mu-IOL group by resting-state fMRI analysis. The different changing trends of postoperative fALFF values in the two groups indicated distinct neuroadaptations patterns after Mu-IOL and Mo-IOL implantation.
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Affiliation(s)
- Li Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Department of Ophthalmology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Wuhan Aier Eye Hospital, Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yong Wang
- Wuhan Aier Eye Hospital, Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Wan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wei Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yi Xiang
- Department of Ophthalmology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Zhu
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Chuan Chen
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Xiying Dong
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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20
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Chen W, Lan L, Xiao W, Li J, Liu J, Zhao F, Wang CD, Zheng Y, Chen W, Cai Y. Reduced Functional Connectivity in Children With Congenital Cataracts Using Resting-State Electroencephalography Measurement. Front Neurosci 2021; 15:657865. [PMID: 33935639 PMCID: PMC8079630 DOI: 10.3389/fnins.2021.657865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/22/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives Numerous task-based functional magnetic resonance imaging studies indicate the presence of compensatory functional improvement in patients with congenital cataracts. However, there is neuroimaging evidence that shows decreased sensory perception or cognition information processing related to visual dysfunction, which favors a general loss hypothesis. This study explored the functional connectivity between visual and other networks in children with congenital cataracts using resting state electroencephalography. Methods Twenty-one children with congenital cataracts (age: 8.02 ± 2.03 years) and thirty-five sex- and age-matched normal sighted controls were enrolled to investigate functional connectivity between the visual cortex and the default mode network, the salience network, and the cerebellum network during resting state electroencephalography (eyes closed) recordings. Result The congenital cataract group was less active, than the control group, in the occipital, temporal, frontal and limbic lobes in the theta, alpha, beta1 and beta2 frequency bands. Additionally, there was reduced alpha-band connectivity between the visual and somatosensory cortices and between regions of the frontal and parietal cortices associated with cognitive and attentive control. Conclusion The results indicate abnormalities in sensory, cognition, motion and execution functional connectivity across the developing brains of children with congenital cataracts when compared with normal controls. Reduced frontal alpha activity and alpha-band connectivity between the visual cortex and salience network might reflect attenuated inhibitory information flow, leading to higher attentional states, which could contribute to adaptation of environmental change in this group of patients.
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Affiliation(s)
- Wan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Liping Lan
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Wei Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jiahong Li
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Jiahao Liu
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Fei Zhao
- Department of Speech and Language Therapy and Hearing Science, Cardiff Metropolitan University, Cardiff, United Kingdom.,Department of Hearing and Speech Science, Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Chang-Dong Wang
- School of Data and Computer Science, Sun Yat-sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
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21
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Lee ATC, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Higher Dementia Incidence in Older Adults with Poor Visual Acuity. J Gerontol A Biol Sci Med Sci 2021; 75:2162-2168. [PMID: 32043518 PMCID: PMC7566398 DOI: 10.1093/gerona/glaa036] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Indexed: 11/13/2022] Open
Abstract
Background Longitudinal evidence of poor visual acuity associating with higher risk of incident dementia is mixed. This study aimed to examine if poor visual acuity was associated with higher dementia incidence in a large community cohort of older adults, independent of the possible biases relating to misclassification error, reverse causality, and confounding effects due to health problems and behaviors. Methods A total of 15,576 community-living older adults without dementia at baseline were followed for 6 years to the outcome of incident dementia, which was diagnosed according to the ICD-10 or a Clinical Dementia Rating of 1 to 3. Visual acuity was assessed using the Snellen’s chart at baseline and follow-up. Important variables including demographics (age, sex, education, and socioeconomic status), physical and psychiatric comorbidities (cardiovascular risks, ophthalmological conditions, hearing impairment, poor mobility, and depression), and lifestyle behaviors (smoking, diet, physical, intellectual, and social activities) were also assessed. Results Over 68,904 person-years of follow-up, 1,349 participants developed dementia. Poorer visual acuity at baseline was associated with higher dementia incidence in 6 years, even after adjusting for demographics, health problems, and lifestyle behaviors, and excluding those who developed dementia within 3 years after baseline. Compared with normal vision, the hazard ratio of dementia was 1.19 (p = .31), 2.09 (p < .001), and 8.66 (p < .001) for mild, moderate, and severe visual impairment, respectively. Conclusions Moderate-to-severe visual impairment could be a potential predictor and possibly a risk factor for dementia. From a clinical perspective, older adults with poor visual acuity might warrant further risk assessment for dementia.
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Affiliation(s)
- Allen T C Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Wai C Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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22
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Hirst RJ, Setti A, De Looze C, Akuffo KO, Peto T, Kenny RA, Newell FN. The effect of eye disease, cataract surgery and hearing aid use on multisensory integration in ageing. Cortex 2020; 133:161-176. [DOI: 10.1016/j.cortex.2020.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/10/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
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23
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BEYOĞLU A, BEYOĞLU MM, URFALIOGLU S, AVCI D, ŞAHİN H, TEKİN S. Senil Katarakta Sahip Hastalarda Cerrahi Öncesi ve Cerrahi Sonrası Görme Keskinliğinin Depresyon ile İlişkisinin İncelenmesi: Çok Merkezli Çalışma. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2020. [DOI: 10.17517/ksutfd.795291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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24
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Piano M, Nilforooshan R, Evans S. Binocular Vision, Visual Function, and Pupil Dynamics in People Living With Dementia and Their Relation to the Rate of Cognitive Decline and Structural Changes Within the Brain: Protocol for an Observational Study. JMIR Res Protoc 2020; 9:e16089. [PMID: 32773379 PMCID: PMC7445601 DOI: 10.2196/16089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 04/24/2020] [Accepted: 05/12/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Visual impairment is a common comorbidity in people living with dementia. Addressing sources of visual difficulties can have a significant impact on the quality of life for people living with dementia and their caregivers. Depth perception problems are purportedly common in dementia and also contribute to falls, visuomotor task difficulties, and poorer psychosocial well-being. However, depth perception and binocular vision are rarely assessed in dementia research. Sleep fragmentation is also common for people living with dementia, and binocular cooperation for depth perception can be affected by fatigue. Pupillary responses under cognitive load also have the potential to be a risk marker for cognitive decline in people living with dementia and can be combined with the above measures for a comprehensive evaluation of clinical visual changes in people living with dementia and their relation to changes in cognitive status, sleep quality, and cortical structure or function. OBJECTIVE This study aims to characterize the nature of clinical visual changes and altered task-evoked pupillary responses that may occur in people living with dementia and evaluate whether these responses relate to changes in cognitive status (standardized Mini Mental State Examination [MMSE] score), Pittsburgh sleep quality index, and cortical structure or function. METHODS This proposed exploratory observational study will enroll ≤210 people with recently diagnosed dementia (within the last 24 months). The following parameters will be assessed on 3 occasions, 4 months apart (plus or minus 2 weeks): visual function (visual acuity and contrast sensitivity), binocular function (motor fusion and stereopsis), task-evoked pupillary responses (minimum and maximum pupil size, time to maximum dilation, and dilation velocity), cognitive status (MMSE score), and sleep quality (Pittsburgh Sleep Quality Index). A subset of patients (n=30) with Alzheimer disease will undergo structural and functional magnetic resonance imaging at first and third visits, completing a 10-day consensus sleep diary to monitor sleep quality, verified by sleep actimetry. RESULTS This research was funded in February 2018 and received National Health Service Research Ethics Committee approval in September 2018. The data collection period was from October 1, 2018, to November 30, 2019. A total of 24 participants were recruited for the study. The data analysis is complete, with results expected to be published before the end of 2020. CONCLUSIONS Findings will demonstrate how often people with dementia experience binocular vision problems. If frequent, diagnosing and treating them could improve quality of life by reducing the risk of falls and fine visuomotor task impairment and by relieving psychosocial anxiety. This research will also demonstrate whether changes in depth perception, pupillary responses, and quality of vision relate to changes in memory or sleep quality and brain structure or function. If related, these quick and noninvasive eye tests help monitor dementia. This would help justify whether binocular vision and pupillary response testing should be included in dementia-friendly eye-testing guidelines. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/16089.
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Affiliation(s)
- Marianne Piano
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Australia
- National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | | | - Simon Evans
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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25
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Manza P, Wiers CE, Shokri-Kojori E, Kroll D, Feldman D, Schwandt M, Wang GJ, Tomasi D, Volkow ND. Brain Network Segregation and Glucose Energy Utilization: Relevance for Age-Related Differences in Cognitive Function. Cereb Cortex 2020; 30:5930-5942. [PMID: 32564073 DOI: 10.1093/cercor/bhaa167] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/19/2022] Open
Abstract
The human brain is organized into segregated networks with strong within-network connections and relatively weaker between-network connections. This "small-world" organization may be essential for maintaining an energetically efficient system, crucial to the brain which consumes 20% of the body's energy. Brain network segregation and glucose energy utilization both change throughout the lifespan. However, it remains unclear whether these processes interact to contribute to differences in cognitive performance with age. To address this, we examined fluorodeoxyglucose-positron emission tomography and resting-state functional magnetic resonance imaging from 88 participants aged 18-73 years old. Consistent with prior work, brain network segregation showed a negative association with age across both sensorimotor and association networks. However, relative glucose metabolism demonstrated an interaction with age, showing a negative slope in association networks but a positive slope in sensorimotor networks. Overall, brain networks with lower segregation showed significantly steeper age-related differences in glucose metabolism, compared with highly segregated networks. Sensorimotor network segregation mediated the association between age and poorer spatial cognition performance, and sensorimotor network metabolism mediated the association between age and slower response time. These data provide evidence that sensorimotor segregation and glucose metabolism underlie some age-related changes in cognition. Interventions that stimulate somatosensory networks could be important for treatment of age-related cognitive decline.
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Affiliation(s)
- Peter Manza
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Corinde E Wiers
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ehsan Shokri-Kojori
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Danielle Kroll
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Dana Feldman
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Melanie Schwandt
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Gene-Jack Wang
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Dardo Tomasi
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nora D Volkow
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA.,National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA
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26
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Pellegrini M, Bernabei F, Schiavi C, Giannaccare G. Impact of cataract surgery on depression and cognitive function: Systematic review and meta‐analysis. Clin Exp Ophthalmol 2020; 48:593-601. [DOI: 10.1111/ceo.13754] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/26/2020] [Accepted: 03/19/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Marco Pellegrini
- Ophthalmology Unit, S.Orsola‐Malpighi University Hospital University of Bologna Bologna Italy
| | - Federico Bernabei
- Ophthalmology Unit, S.Orsola‐Malpighi University Hospital University of Bologna Bologna Italy
| | - Costantino Schiavi
- Ophthalmology Unit, S.Orsola‐Malpighi University Hospital University of Bologna Bologna Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology University Magna Græcia of Catanzaro Catanzaro Italy
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27
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Chellappa SL, Bromundt V, Frey S, Schlote T, Goldblum D, Cajochen C, Reichert CF. Intraocular cataract lens replacement and light exposure potentially impact procedural learning in older adults. J Sleep Res 2020; 30:e13043. [PMID: 32285996 DOI: 10.1111/jsr.13043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 03/03/2020] [Accepted: 03/17/2020] [Indexed: 02/03/2023]
Abstract
Procedural learning declines with age and appropriately timed light exposure can improve cognitive performance in older individuals. Because cataract reduces light transmission and is associated with cognitive decline in older adults, we explored whether lens replacement (intraocular blue-blocking [BB] or UV-only blocking) in older patients with cataracts enhances the beneficial effects of light on procedural learning. Healthy older participants (n = 16) and older patients with post-cataract surgery (n = 13 with BB or UV lens replacement) underwent a randomized within-subject crossover laboratory design with three protocols. In each protocol, 3.5 hr dim-dark adaptation was followed by 2 hr evening blue-enriched (6,500K) or non-blue-enriched light exposure (3,000K or 2,500K), 30 min dim post-light, ~8 hr sleep and 2 hr morning dim light. Procedural learning was assessed by the alternating serial reaction time task (ASRT), as part of a larger test battery. Here, ASRT performance was indexed by type of trial (random or sequence) and sequence-specific (high or low probability) measures. During evening light exposure, we observed a significant effect of the interaction of "group" versus "light condition" on the type of trial (p = .04; p = .16; unadjusted and adjusted p-values, respectively) and sequence-specific learning (p = .04; p = .16; unadjusted and adjusted p-values, respectively), whereby patients with UV lens replacement performed better than patients with BB lens or non-cataract controls, during blue-enriched light exposure. Lens replacement in patients with cataracts may potentially be associated with beneficial effects of blue light on procedural learning. Thus, optimizing spectral lens transmission in patients with cataracts may help improve specific aspects of cognitive function, such as procedural learning.
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Affiliation(s)
- Sarah L Chellappa
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Vivien Bromundt
- Department of Neurology, Sleep Wake Epilepsy Center, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Sylvia Frey
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | | | - David Goldblum
- Department of Ophthalmology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Christian Cajochen
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Carolin F Reichert
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
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28
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Lim ZW, Chee ML, Da Soh Z, Cheung N, Dai W, Sahil T, Tao Y, Majithia S, Sabanayagam C, Chen CLH, Wong TY, Cheng CY, Tham YC. Association Between Visual Impairment and Decline in Cognitive Function in a Multiethnic Asian Population. JAMA Netw Open 2020; 3:e203560. [PMID: 32324240 PMCID: PMC7180417 DOI: 10.1001/jamanetworkopen.2020.3560] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IMPORTANCE With the rapidly aging population, the burden of visual impairment (VI) and cognitive decline is expected to increase. Previous cross-sectional studies suggest an association between these 2 health outcomes. However, few longitudinal reports have examined this association, and to our knowledge, no studies have been performed in Asian populations. Further investigation on this association may help to better identify individuals at risk of cognitive decline. OBJECTIVE To examine the longitudinal association between VI and decline in cognitive function in a multiethnic Asian population. DESIGN, SETTING, AND PARTICIPANTS In this longitudinal, population-based, prospective cohort study, Chinese, Indian, and Malay adults 60 years or older at baseline were recruited from the Singapore Epidemiology of Eye Diseases (SEED) study. At baseline, participants from the SEED study were recruited under 3 studies: the Singapore Malay Eye Study (SiMES; 2004-2006), the Singapore Indian Eye Study (SINDI; 2007-2009), and the Singapore Chinese Eye Study (SCES; 2009-2011). Eligible participants were reexamined after 6 years (2011-2013 for SiMES, 2013-2015 for SINDI, and 2015-2017 for SCES). Data analysis was performed from November 1 to 24, 2019. EXPOSURES Visual impariment was defined as presenting visual acuity worse than 20/40 based on the better-seeing eye. MAIN OUTCOMES AND MEASURES Cognitive function was assessed using a locally validated Abbreviated Mental Test (AMT). The association between baseline VI and change in AMT score was determined using the multivariable linear regression model adjusting for baseline age; sex; race/ethnicity; presence of diabetes, hyperlipidemia, hypertension, and chronic kidney disease; history of cardiovascular disease; smoking status; alcohol intake; body mass index; educational status; and AMT score. RESULTS A total of 2478 individuals (1256 [50.7%] male; 1073 Chinese, 768 Indian, and 637 Malay adults) with mean (SD) age of 67.6 (5.6) years were evaluated, of whom 489 (19.7%) had reduction in AMT scores over 6 years. Baseline VI was associated with a decrease in AMT score over 6 years (β = -0.27; 95% CI, -0.37 to -0.17; P < .001). When change in vision over 6 years was evaluated, unchanged or deteriorated VI was associated with a decrease in AMT score over 6 years (β = -0.29; 95% CI, -0.40 to -0.18; P < .001). Among individuals with baseline VI and a substantial decrease in AMT score of 3 units or more over 6 years, the leading causes of VI were undercorrected refractive error (14 [45.2%]) and cataract (11 [35.5%]). CONCLUSIONS AND RELEVANCE In this study, poor vision was independently associated with a decline in cognitive function. Causes of visual loss in these cases were mostly preventable, further suggesting that preserving good vision may be an important interventional strategy for mitigating cognitive decline.
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Affiliation(s)
- Zhi Wei Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Miao-Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ning Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Wei Dai
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Thakur Sahil
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Yijin Tao
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Christopher Li-Hsian Chen
- Memory Aging and Cognition Centre, National University Health System, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
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29
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Loganovsky KN, Fedirko PA, Kuts KV, Marazziti D, Antypchuk KY, Perchuk IV, Babenko TF, Loganovska TK, Kolosynska OO, Kreinis GY, Gresko MV, Masiuk SV, Zdorenko LL, Zdanevich NA, Garkava NA, Dorichevska RY, Vasilenko ZL, Kravchenko VI, Drosdova NV, Yefimova YV. BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. Part І. THE CONSEQUENCES OF IRRADIATION OF THE PARTICIPANTS OF THE LIQUIDATION OF THE CHORNOBYL ACCIDENT. PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2020; 25:90-129. [PMID: 33361831 DOI: 10.33145/2304-8336-2020-25-90-129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Exposure to ionizing radiation could affect the brain and eyes leading to cognitive and vision impairment, behavior disorders and performance decrement during professional irradiation at medical radiology, includinginterventional radiological procedures, long-term space flights, and radiation accidents. OBJECTIVE The objective was to analyze the current experimental, epidemiological, and clinical data on the radiation cerebro-ophthalmic effects. MATERIALS AND METHODS In our analytical review peer-reviewed publications via the bibliographic and scientometric bases PubMed / MEDLINE, Scopus, Web of Science, and selected papers from the library catalog of NRCRM - theleading institution in the field of studying the medical effects of ionizing radiation - were used. RESULTS The probable radiation-induced cerebro-ophthalmic effects in human adults comprise radiation cataracts,radiation glaucoma, radiation-induced optic neuropathy, retinopathies, angiopathies as well as specific neurocognitive deficit in the various neuropsychiatric pathology including cerebrovascular pathology and neurodegenerativediseases. Specific attention is paid to the likely stochastic nature of many of those effects. Those prenatally and inchildhood exposed are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. CONCLUSIONS The experimental, clinical, epidemiological, anatomical and pathophysiological rationale for visualsystem and central nervous system (CNS) radiosensitivity is given. The necessity for further international studieswith adequate dosimetric support and the follow-up medical and biophysical monitoring of high radiation riskcohorts is justified. The first part of the study currently being published presents the results of the study of theeffects of irradiation in the participants of emergency works at the Chornobyl Nuclear Power Plant (ChNPP).
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Affiliation(s)
- K N Loganovsky
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - P A Fedirko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - K V Kuts
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - D Marazziti
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100, Pisa, Italy
| | - K Yu Antypchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - I V Perchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - T F Babenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - T K Loganovska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - O O Kolosynska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - G Yu Kreinis
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - M V Gresko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - S V Masiuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - L L Zdorenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N A Zdanevich
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N A Garkava
- State Institution «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», 9 Vernadsky Street, Dnipro, 49044, Ukraine
| | - R Yu Dorichevska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - Z L Vasilenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - V I Kravchenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N V Drosdova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - Yu V Yefimova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
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30
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Lin ZL, Lin DR, Chen JJ, Li J, Li XY, Wang LS, Liu ZZ, Cao QZ, Chen C, Zhu Y, Chen WR, Liu YZ, Lin HT. Increased prevalence of parent ratings of ADHD symptoms among children with bilateral congenital cataracts. Int J Ophthalmol 2019; 12:1323-1329. [PMID: 31456924 DOI: 10.18240/ijo.2019.08.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/14/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder (ADHD) symptoms among children with bilateral congenital cataracts (CCs). METHODS This cross-sectional study investigated children with bilateral CC aged 3-8y (CC group) using Conners' Parent Rating Scale-48 (CPRS-48) from July to December 2016. The abnormal rates of psychological symptoms in CC children and normal vision (NV) children were compared using the Chi-square test. The scores of CC children were compared with those of NV children and the Chinese urban norm using the independent samples t-test and one-sample t-test, respectively. RESULTS A total of 262 valid questionnaires were collected. The ratio of CC children to NV children was 119:143. The overall rate of psychological symptoms in CC children was 2.28 times higher than that in NV children (46.22% vs 20.28%, Pearson's χ 2=20.062; P<0.001). CC children showed higher scores for conduct problems, learning problems, impulsiveness/hyperactivity, anxiety, and hyperactivity index than NV children and the Chinese urban norm, particularly between the ages of 3 and 5y. Furthermore, male children aged between 6 and 8y showed a higher impulsive/hyperactive score than females of the same age (t=6.083, P<0.001). CONCLUSION Children with bilateral CCs have a higher rate of ADHD symptoms than children with NV. This study provides clinical evidence that screening for psychological symptoms and particularly for ADHD symptoms in children with bilateral CC are recommended for an early diagnosis and timely treatment.
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Affiliation(s)
- Zhuo-Ling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Duo-Ru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing-Jing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Yan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Li-Sha Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zhen-Zhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Qian-Zhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Wei-Rong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Yi-Zhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hao-Tian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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31
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Leon M, Woo C. Environmental Enrichment and Successful Aging. Front Behav Neurosci 2018; 12:155. [PMID: 30083097 PMCID: PMC6065351 DOI: 10.3389/fnbeh.2018.00155] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/04/2018] [Indexed: 12/18/2022] Open
Abstract
The human brain sustains a slow but progressive decline in function as it ages and these changes are particularly profound in cognitive processing. A potential contributor to this deterioration is the gradual decline in the functioning of multiple sensory systems and the effects they have on areas of the brain that mediate cognitive function. In older adults, diminished capacity is typically observed in the visual, auditory, masticatory, olfactory, and motor systems, and these age-related declines are associated with both a decline in cognitive proficiency, and a loss of neurons in regions of the brain. We will review how the loss of hearing, vision, mastication skills, olfactory impairment, and motoric decline accompany cognitive loss, and how improved functioning of these systems may aid in the restoration of the cognitive abilities in older adults. The human brain appears to require a great deal of stimulation to maintain its cognitive efficacy as people age and environmental enrichment may aid in its maintenance and recovery.
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Affiliation(s)
- Michael Leon
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Cynthia Woo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
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