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Cheung ESL, Zhang Z. Moderating Role of Neighborhood Environment in the Associations Between Hearing Loss and Cognitive Challenges Among Older Adults: Evidence From US National Study. Res Aging 2024; 46:400-413. [PMID: 38361482 DOI: 10.1177/01640275241234372] [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] [Indexed: 02/17/2024]
Abstract
This study examined the associations between hearing loss and cognitive challenges among community-dwelling older adults and whether neighborhood characteristics (physical disorder and low social cohesion) moderated the associations. Cross-sectional national data from Round 11 of the National Health and Aging Trends Study were adopted (N = 2,515). Multinomial logistic regressions were used to examine associations among variables and interactive analyses were conducted to examine moderating effects. Results indicated significant relationships between the experience of hearing loss and possible dementia and between severe or profound hearing loss and probable dementia. Interactive models suggested that residing in neighborhoods with physical disorder and low social cohesion were negatively associated with possible dementia among older adults with moderate and severe or profound hearing loss, respectively, compared to those without hearing loss. Findings underscore the necessity of environmental and social interventions to enhance cognitive health among older adults with varying degrees of hearing challenges.
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Affiliation(s)
| | - Zhe Zhang
- Teachers College, Columbia University, New York, NY, USA
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2
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Wang L, Sang B, Zheng Z. The risk of dementia or cognitive impairment in patients with cataracts: a systematic review and meta-analysis. Aging Ment Health 2024; 28:11-22. [PMID: 37416949 DOI: 10.1080/13607863.2023.2226616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/04/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVES The aim of this study was to investigate whether cataract disease is associated with the risk of developing dementia or cognitive impairment. METHODS A systematic search of the literature in PubMed, the Extracts Database (Embase), the Cochrane Library and the Web of Science databases was performed from the inception data of each database until 1 September 2022. Sensitivity analyses were performed to assess the robustness and reliability of the overall findings. All extracted data were statistically analyzed using Stata software v.16.0. Publication bias was assessed using funnel plots and the Egger test. RESULTS There were 11 publications included in this study, which consisted of 489,211participants, spanning 10 countries from 2012 to 2022. Aggregation suggested that cataracts were associated with cognitive impairment (odds ratio [OR] = 1.32; 95% CI: 1.21-1.43; I 2 = 45.4.%; p = 0.000). The presence of cataracts is significantly associated with an increased risk of developing all-cause dementia (relative risk [RR] = 1.17; 95% CI: 1.08-1.26; I2 = 0.0%; p = 0.000). In subgroup analyses, having cataracts may increase the risk of Alzheimer's disease (hazard ratio [HR] = 1.28; 95% CI: 1.13-1.45; I2 = 0.0%; p = 0.000) and vascular dementia (HR = 1.35; 95% CI = 1.06-1.73; I2 = 0.0%, p = 0.015). The data from the Egger's test showed no significant evidence of publication bias. CONCLUSIONS Cataracts are associated with the risk of cognitive impairment and dementia, including Alzheimer's disease, and vascular dementia.
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Affiliation(s)
- Luping Wang
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Bowen Sang
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Zuyan Zheng
- Department of Acupuncture, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
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3
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Almidani L, Varadaraj V, Mihailovic A, Ramulu PY. Using Objective Vision Measures to Explore the Association of Vision Impairment With Cognition Among Older Adults in the United States. Am J Ophthalmol 2023; 255:18-29. [PMID: 37286156 DOI: 10.1016/j.ajo.2023.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/14/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To evaluate the association between vision impairment (VI) and cognitive function using objective measures. DESIGN Cross-sectional analysis with a nationally representative sample. METHODS The association between VI and dementia was investigated in a US population-based, nationally representative sample of Medicare beneficiaries, the National Health and Aging Trends Study (NHATS), a nationally representative sample of Medicare beneficiaries aged ≥65 years, using objective vision measures. Exposures included distance VI (>20/40), near VI (>20/40), contrast sensitivity impairment (CSI) (<1.55), any objective VI (distance and near visual acuity, or contrast), and self-reported VI. The main outcome measure was dementia status defined based on survey reports, interviews, and cognitive tests. RESULTS A total of 3026 adults were included in this study; the majority were female (55%) and White (82%). The weighted prevalence rates were 10% for distance VI, 22% for near VI, 22% for CSI, 34% for any objective VI, and 7% for self-reported VI. Across all measures of VI, dementia was more than twice as prevalent in adults with VI compared to their peers without (P < .001 for all). In adjusted models, all measures of VI were associated with higher odds of dementia (distance VI: OR 1.74, 95% CI 1.24-2.44; near VI: OR 1.68, 95% CI 1.29-2.18; CSI: OR 1.95, 95% CI 1.45-2.62; any objective VI: OR 1.83, 95% CI 1.43-2.35; self-reported VI: OR 1.86, 95% CI 1.20-2.89). CONCLUSIONS In a nationally representative sample of older US adults, VI was associated with increased odds of dementia. These results suggest that maintaining good vision and eye health may help preserve cognitive function in older age, although more research is needed to investigate the potential benefits of interventions that focus on vision and eye health on cognitive outcomes.
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Affiliation(s)
- Louay Almidani
- From the Wilmer Eye Institute, Johns Hopkins University School of Medicine (L.A., A.M., P.Y.R.); Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing (V.V.), Baltimore, Maryland, USA
| | - Varshini Varadaraj
- From the Wilmer Eye Institute, Johns Hopkins University School of Medicine (L.A., A.M., P.Y.R.); Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing (V.V.), Baltimore, Maryland, USA
| | - Aleksandra Mihailovic
- From the Wilmer Eye Institute, Johns Hopkins University School of Medicine (L.A., A.M., P.Y.R.); Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing (V.V.), Baltimore, Maryland, USA
| | - Pradeep Y Ramulu
- From the Wilmer Eye Institute, Johns Hopkins University School of Medicine (L.A., A.M., P.Y.R.); Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing (V.V.), Baltimore, Maryland, USA..
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4
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Feng J, Huang C, Liang L, Li C, Wang X, Ma J, Guan X, Jiang B, Huang S, Qin P. The Association Between Eye Disease and Incidence of Dementia: Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:1363-1373.e6. [PMID: 37527793 DOI: 10.1016/j.jamda.2023.06.025] [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: 03/09/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES To better demonstrate the relationship between common eye diseases and the risk of dementia, we conducted a systematic review and meta-analysis of cohort studies to investigate the relationship between common eye diseases and dementia. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Patients with common eye diseases. METHODS We conducted a systematic search of articles published up to August 25, 2022, of online databases including PubMed, EMBASE, and Web of Science. We included cohort studies that evaluated the association of glaucoma, age-related macular degeneration (AMD), diabetic retinopathy (DR), and cataracts with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD). Relative risks (RRs) and 95% CIs were pooled using random effects model, and heterogeneity was assessed by the I2 statistic. Subgroup analysis and sensitivity analysis were also performed. RESULTS In total, 25 studies were included in the meta-analysis, with a total of 11,410,709 participants. Pooled estimates suggested an increased risk of all-cause dementia associated with AMD (RR, 1.29; 95% CI, 1.13-1.48), glaucoma (RR, 1.16; 95% CI, 1.03-1.32), DR (RR, 1.40; 95% CI, 1.21-1.63), and cataract (RR,1.23; 95% CI, 1.09-1.40); an increased risk of AD associated with AMD (RR, 1.27; 95% CI, 1.06-1.52), glaucoma (RR, 1.18; 95% CI, 1.02-1.38), DR (RR, 1.21; 95% CI, 1.04-1.41), and cataracts (RR,1.22; 95% CI, 1.07-1.38). No association was observed between incident VaD and any eye diseases. The results of subgroup analyses were consistent with those in meta-analysis of DR and risk of all-cause dementia. Meta-regressions suggested geographic regions as potential sources of heterogeneity for the association between AMD and all-cause dementia, AMD and AD, glaucoma and dementia, glaucoma, and AD, respectively. CONCLUSIONS AND IMPLICATIONS AMD, glaucoma, DR, and cataract may be associated with an increased risk of all-cause dementia and AD, but not VaD. However, the results should be interpreted cautiously because of the high heterogeneity and unstable findings in some subgroup analyses.
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Affiliation(s)
- Jiayi Feng
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China; College of Medicine, Shantou University, Shantou, Guangdong, China
| | - Cuihong Huang
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China; Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lei Liang
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Chuang Li
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China; College of Medicine, Shantou University, Shantou, Guangdong, China
| | - Xiaojie Wang
- Department of Neurology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Jianping Ma
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Xinhui Guan
- Ophthalmology Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Bin Jiang
- Department of Neurology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Shaofen Huang
- Department of Public Health, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Pei Qin
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China.
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Killeen OJ, Zhou Y, Ehrlich JR. Objectively Measured Visual Impairment and Dementia Prevalence in Older Adults in the US. JAMA Ophthalmol 2023; 141:786-790. [PMID: 37440238 PMCID: PMC10346499 DOI: 10.1001/jamaophthalmol.2023.2854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/14/2023] [Indexed: 07/14/2023]
Abstract
Importance Estimates of the association between visual impairment (VI) and dementia in the US population are based on self-reported survey data or measures of visual function that are at least 15 years old. Older adults are at high risk of VI and dementia so there is a need for up-to-date national estimates based on objective assessments. Objective To estimate the association between VI and dementia in older US adults based on objective visual and cognitive function testing. Design, Setting, and Participants This secondary analysis of the 2021 National Health and Aging Trends Study (NHATS), a population-based, nationally representative panel study, included 3817 respondents 71 years and older. Data were analyzed from January to March 2023. Intervention In 2021, NHATS incorporated tablet-based tests of distance and near visual acuity and contrast sensitivity (CS) with habitual correction. Main Outcomes and Measures VI was defined as distance visual acuity more than 0.30 logMAR, near visual acuity more than 0.30 logMAR, and CS more than 1 SD below the sample mean. Dementia was defined as scoring 1.5 SDs or more below the mean in 1 or more cognitive domains, an AD8 Dementia Screening Interview Score indicating probable dementia, or diagnosed dementia. Poisson regression estimated dementia prevalence ratios adjusted for covariates. Results Of 2967 included participants, 1707 (weighted percentage, 55.3%) were female, and the median (IQR) age was 76.9 (77-86) years. The weighted prevalence of dementia was 12.3% (95% CI, 10.9-13.7) and increased with near VI (21.5%; 95% CI, 17.7-25.3), distance VI (mild: 19.1%; 95% CI, 13.0-25.2; moderate, severe, or blind: 32.9%; 95% CI, 24.1- 41.8), and CS impairment (25.9%; 95% CI, 20.5-31.3). Dementia prevalence was higher among participants with near VI and CS impairment than those without (near VI prevalence ratio: 1.40; 95% CI, 1.16-1.69; CS impairment prevalence ratio: 1.31; 95% CI, 1.04-1.66) and among participants with moderate to severe distance VI or blindness (prevalence ratio: 1.72; 95% CI, 1.26-2.35) after adjustment for covariates. Conclusions and Relevance In this survey study, all types of objectively measured VI were associated with a higher dementia prevalence. As most VI is preventable, prioritizing vision health may be important for optimizing cognitive function.
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Affiliation(s)
- Olivia J. Killeen
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
| | - Yunshu Zhou
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
| | - Joshua R. Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
- Institute for Social Research, University of Michigan, Ann Arbor
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6
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Luo Y, Chen Y, Wang K, De Fries CM, Huang Z, Xu H, Yang Z, Hu Y, Xu B. Associations between multimorbidity and frailty transitions among older Americans. J Cachexia Sarcopenia Muscle 2023; 14:1075-1082. [PMID: 36852679 PMCID: PMC10067509 DOI: 10.1002/jcsm.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/02/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND The associations of multimorbidity patterns with transitions between frailty states remain unclear in older individuals. METHODS We used data from the National Health and Aging Trends Study 2011-2019. Frailty was measured annually using the Fried frailty phenotype. Multimorbidity patterns at baseline were identified using latent class analysis based on 14 chronic conditions. We used the semi-Markov multi-state model to investigate the influences of multimorbidity characterized by condition counts and patterns on subsequent frailty transitions over follow-ups. RESULTS Among 9450 participants aged ≥65 years at baseline, 34.8% were non-frail, 48.1% were pre-frail and 17.0% were frail. Over a median follow-up of 4.0 years, 16 880 frailty transitions were observed, with 10 527 worsening and 6353 improving. For 7675 participants with multimorbidity, four multimorbidity patterns were identified: osteoarticular pattern (62.4%), neuropsychiatric-sensory pattern (17.2%), cardiometabolic pattern (10.3%) and complex multimorbidity pattern (10.1%). Compared with no disease, multimorbidity was significantly associated with an increased risk of worsening transitions, including from non-frail to pre-frail (hazard ratio [HR] = 1.35; 95% confidence interval [CI] = 1.21-1.52), from non-frail to frail (HR = 1.68; 95% CI = 1.04-2.73), from pre-frail to frail (HR = 2.19; 95% CI = 1.66-2.90) and from pre-frail to death (HR = 1.64; 95% CI = 1.11-2.41). Compared with the osteoarticular pattern, neuropsychiatric-sensory, cardiometabolic and complex multimorbidity patterns had a significantly higher risk of worsening frailty (all P < 0.05). CONCLUSIONS Multimorbidity was associated with dynamic transitions between frailty states and death among older American adults, and the associations varied across multimorbidity patterns. The findings could offer significant implications for public health policymakers in planning interventions and healthcare resources. They also might inform clinicians regarding providing targeted clinical treatment and health management based on multimorbidity patterns of older people.
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Affiliation(s)
- Yan Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Yuming Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Carson M De Fries
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Ziting Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Huiwen Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Zhou Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Beibei Xu
- Medical Informatics Center, Peking University, Beijing, China
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7
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Nichols E, Ng DK, James BD, Deal JA, Gross AL. The application of cross-sectionally derived dementia algorithms to longitudinal data in risk factor analyses. Ann Epidemiol 2023; 77:78-84. [PMID: 36470322 PMCID: PMC9924954 DOI: 10.1016/j.annepidem.2022.11.006] [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: 07/14/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Dementia algorithms are often developed in cross-sectional samples but implemented in longitudinal studies to ascertain incident dementia. However, algorithm performance may be higher in cross-sectional settings, and this may impact estimates of risk factor associations. METHODS We used data from the Religious Orders Study and the Memory and Aging Project (N = 3460) to assess the performance of example algorithms in classifying prevalent dementia in cross-sectional samples versus incident dementia in longitudinal samples. We used an applied example and simulation study to characterize the impact of varying sensitivity, specificity, and unequal sensitivity or specificity between exposure groups (differential performance) on estimated hazard ratios from Cox models. RESULTS Using all items, algorithm sensitivity was higher for prevalent (0.796) versus incident dementia (0.719); hazard ratios had slight bias. Sensitivity differences were larger using a subset of items (0.732 vs. 0.600) and hazard ratios were 13%-19% higher across adjustment sets compared to estimates using gold-standard dementia status. Simulations indicated specificity and differential algorithmic performance between exposure groups may have large effects on hazard ratios. CONCLUSIONS Algorithms developed using cross-sectional data may be adequate for longitudinal settings when performance is high and non-differential. Poor specificity or differential performance between exposure groups may lead to biases.
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Affiliation(s)
- Emma Nichols
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Derek K Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Bryan D James
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL; Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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8
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Li JM, Boustani MA, French DD. Social Determinants of Health in Community-Dwelling Dementia Patients Aged 65 and Over: Analysis of the 2019 National Health Interview Survey. Gerontol Geriatr Med 2023; 9:23337214231190244. [PMID: 37538837 PMCID: PMC10395185 DOI: 10.1177/23337214231190244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/19/2023] [Accepted: 07/10/2023] [Indexed: 08/05/2023] Open
Abstract
Alzheimer's Disease and related dementias affect 3.4 million community-dwelling adults in the United States. Given the burden of disease, a greater understanding of modifiable risk factors is crucial for targeted public health strategies. Social determinants of health (SDOH) are modifiable risk factors categorized in five domains: economic status, education, healthcare access, environment, and community context. Although individual SDOH have been linked to dementia, limited research exists on the interaction of SDOH with dementia across multiple domains. The aim of this study was to evaluate the association between SDOH across all five domains and dementia among community-dwelling adults in the United States. A cross-sectional study was performed on community-dwelling adults aged ≥65 years from the 2019 National Health Interview Survey (NHIS). Respondents (N = 9,277), of whom 303 (4%) self-reported positive dementia diagnosis, were predominantly female (55%), white (76%), and non-Hispanic (91%). Residing in a non-metropolitan area, having a usual place for healthcare, and receiving annual eye or dental exams were negatively associated with dementia. Minority compared to white status was not significantly associated with dementia, suggesting underdiagnosis of dementia within minority groups in the NHIS. We present the first comprehensive national view of SDOH among community-dwelling dementia patients in the United States.
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Affiliation(s)
- Joanne M. Li
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Dustin D. French
- Northwestern University, Feinberg School of Medicine, Departments of Ophthalmology, Medical Social Sciences, and Center for Health Services & Outcomes Research, Chicago, IL, USA
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9
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Papageorgiou E, Tsirelis D, Lazari K, Siokas V, Dardiotis E, Tsironi EE. Visual disorders and driving ability in persons with dementia: A mini review. Front Hum Neurosci 2022; 16:932820. [DOI: 10.3389/fnhum.2022.932820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
BackgroundImpaired driving ability in patients with Alzheimer’s disease (AD) is associated with a decline in cognitive processes and a deterioration of their basic sensory visual functions. Although a variety of ocular abnormalities have been described in patients with AD, little is known about the impact of those visual disorders on their driving performance.AimAim of this mini-review is to provide an update on the driving ability of patients with dementia and summarize the primary visual disorders affecting their driving behavior.MethodsDatabases were screened for studies investigating dementia, associated visual abnormalities and driving ability.ResultsThere is consistent evidence that dementia affects driving ability. Patients with dementia present with a variety of visual disorders, such as visual acuity reduction, visual field defects, impaired contrast sensitivity, decline in color vision and age-related pathological changes, that may have a negative impact on their driving ability. However, there is a paucity in studies describing the impact of oculovisual decline on the driving ability of AD subjects. A bidirectional association between cognitive and visual impairment (VI) has been described.ConclusionGiven the bidirectional association between VI and dementia, vision screening and cognitive assessment of the older driver should aim to identify at-risk individuals and employ timely strategies for treatment of both cognitive and ocular problems. Future studies should characterize the basic visual sensory status of AD patients participating in driving studies, and investigate the impact of vision abnormalities on their driving performance.
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10
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Kwok CPC, Kwok JOT, Yan RWK, Lee KKW, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW, Lee ATC. Dementia and risk of visual impairment in Chinese older adults. Sci Rep 2022; 12:18033. [PMID: 36302807 PMCID: PMC9613925 DOI: 10.1038/s41598-022-22785-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/19/2022] [Indexed: 01/24/2023] Open
Abstract
We had previously identified visual impairment increasing risk of incident dementia. While a bi-directional vision-cognition association has subsequently been proposed, no study has specifically examined the longitudinal association between dementia and incidence of clinically defined visual impairment. In this territory-wide community cohort study of 10,806 visually unimpaired older adults, we examined their visual acuity annually for 6 years and tested if dementia at baseline was independently associated with higher risk of incident visual impairment (LogMAR ≥ 0.50 in the better eye despite best correction, which is equivalent to moderate visual impairment according to the World Health Organization definition). By the end of Year 6, a total of 3151 (29.2%) participants developed visual impairment. However, we did not find baseline dementia associating with higher risk of incident visual impairment, after controlling for baseline visual acuity, cataract, glaucoma, diabetes, hypertension, hypercholesterolemia, heart diseases, stroke, Parkinson's disease, depression, hearing and physical impairments, physical, intellectual and social activities, diet, smoking, age, sex, educational level, and socioeconomic status. Among different covariables, baseline visual acuity appears to be more important than dementia in contributing to the development of visual impairment. Our present findings highlight the need for re-evaluating whether dementia is indeed a risk factor for visual impairment.
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Affiliation(s)
- Charlotte P C Kwok
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jessie O T Kwok
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Rachel W K Yan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kaspar K W Lee
- Department of Psychiatry, Faculty of Medicine, 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, Faculty of Medicine, 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, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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11
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Hou T, Liu M, Zhang J. Bidirectional association between visual impairment and frailty among community-dwelling older adults: a longitudinal study. BMC Geriatr 2022; 22:672. [PMID: 35971062 PMCID: PMC9377125 DOI: 10.1186/s12877-022-03365-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Vision impairment is common among older adults, and it may be related to frailty. However, the longitudinal relationship between visual impairment and frailty is still unclear. Methods We used data from Round 1 to Round 5 from the National Health and Aging Trend Study. Two samples were community-dwelling older adults, sample 1 (without visual impairment) was classified according to whether they have pre-frailty/frailty at R1 (N = 3013) and sample 2 (without pre-frailty/frailty) was classified according to whether they have visual impairment at R1 (N = 1422), respectively. Frailty was measured using five criteria: experiencing exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength. Visual impairment was assessed by asking participants if they had any visual impairment. Generalized estimating equation models were used to examine the concurrent and lagged association between visual impairment and frailty. Results The participants were on average 76 ± 7 years old, female (59%), non-Hispanic white (74%) with less than bachelor educated (73%), and 44% were pre-frail/frail in the older adults without visual impairment. Approximately 5% of participants had visual impairment at R1, and they tended to be female and non-Hispanic White in the older adults without frailty. The concurrent (OR, 95% CI = 1.55, 1.17-2.02) and lagged (OR, 95% CI = 1.79, 1.25-2.59) associations between frailty and visual impairment were significantly after controlling the covariates. Similarly, the concurrent (OR, 95% CI = 1.63, 1.32-2.04) and lagged (OR, 95% CI = 1.49, 1.20-1.87) associations between visual impairment and frailty were also significant. Conclusions Overall, this study provides evidence for a longitudinal, bidirectional association between self-reported visual impairment and frailty. Future intervention programs to delay frailty progression should include strategies that may reduce the incidence of visual impairment.
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Affiliation(s)
- Tianxue Hou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Kaifu District, Changsha, Hunan, 410008, People's Republic of China.,Central South University Xiangya School of Nursing, Changsha, Hunan, China
| | - Minhui Liu
- Central South University Xiangya School of Nursing, Changsha, Hunan, China.,Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Jinghui Zhang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Kaifu District, Changsha, Hunan, 410008, People's Republic of China. .,Central South University Xiangya School of Nursing, Changsha, Hunan, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, People's Republic of China.
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12
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Yu WS, Aquili L, Wong KH, Lo ACY, Chan LLH, Chan YS, Lim LW. Transcorneal electrical stimulation enhances cognitive functions in aged and 5XFAD mouse models. Ann N Y Acad Sci 2022; 1515:249-265. [PMID: 35751874 DOI: 10.1111/nyas.14850] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Dementia is a major burden on global health for which there are no effective treatments. The use of noninvasive visual stimulation to ameliorate cognitive deficits is a novel concept that may be applicable for treating dementia. In this study, we investigated the effects of transcorneal electrical stimulation (TES) on memory enhancement using two mouse models, in aged mice and in the 5XFAD model of Alzheimer's disease. After 3 weeks of TES treatment, mice were subjected to Y-maze and Morris water maze tests to assess hippocampal-dependent learning and memory. Immunostaining of the hippocampus of 5XFAD mice was also performed to examine the effects of TES on amyloid plaque pathology. The results showed that TES improved the performance of both aged and 5XFAD mice in memory tests. TES also reduced hippocampal plaque deposition in male, but not female, 5XFAD mice. Moreover, TES significantly reversed the downregulated level of postsynaptic protein 95 in the hippocampus of male 5XFAD mice, suggesting the effects of TES involve a postsynaptic mechanism. Overall, these findings support further investigation of TES as a potential treatment for cognitive dysfunction and mechanistic studies of TES effects in other dementia models.
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Affiliation(s)
- Wing Shan Yu
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Luca Aquili
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Discipline of Psychology, College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - Kah Hui Wong
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Faculty of Medicine, Department of Anatomy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amy Cheuk Yin Lo
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Leanne Lai Hang Chan
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Ying-Shing Chan
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Lee Wei Lim
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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13
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Vu TA, Gupta P, Leow FZY, Fenwick EK, Man REK, Tham YC, Xu X, Quek DQY, Qian C, Sabanayagam C, Chen CLH, Wong TY, Cheng CY, Lamoureux EL. The longitudinal association between cognitive impairment and incident visual impairment in a multiethnic Asian population: a prospective cohort study. Age Ageing 2022; 51:6593706. [PMID: 35639799 DOI: 10.1093/ageing/afac107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The relationship between baseline cognitive impairment (CI) and incident visual impairment (VI) in Asians is unclear. OBJECTIVE To determine the associations between baseline CI with incident VI and visual acuity (VA) at 6-year follow-up in multiethnic Asians. DESIGN Cohort. SETTING Population-based. SUBJECTS Two thousand three hundred and twenty-four adults aged ≥60 years from the Singapore Epidemiology of Eye Diseases Study (response rate 64%). METHODS CI was defined using the validated Abbreviated Mental Test (AMT). VA was objectively measured using a LogMAR chart. Any incident VI was defined as having no VI (Snellen's VA better than or equal to 20/40) at baseline but present (VA worse than 20/40) at 6-year follow-up. VI severity was defined according to the International Classification of Diseases, 11th Revision. Associations were assessed using logistic and linear regression models. RESULTS Of the 2,324 participants, 248 had CI at baseline. Presence of baseline CI was associated with more than twice the odds of any incident VI, incident mild and moderate-severe VI (OR [95% confidence interval]: 2.48 [1.55-3.90], 2.07 [1.17-3.55], and 2.61 [1.36-4.93], respectively) and worse VA (β [95% confidence interval]: 0.026 [0.006-0.046]) at 6-year follow-up. The leading causes of incident VI were cataract and under-corrected refractive error. CONCLUSIONS Older adults with CI had more than double the odds of VI development and poorer VA than their cognitively intact counterparts, and most causes of incident VI were correctable. Strategies such as targeted vision screening and early intervention for early detection and management of vision loss in patients with cognitive decline are warranted.
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Affiliation(s)
- Tai Anh Vu
- Health Services & Systems Research , Duke-NUS Medical School, Singapore
| | - Preeti Gupta
- Health Services & Systems Research , Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Felicia Z Y Leow
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Eva K Fenwick
- Health Services & Systems Research , Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Ryan E K Man
- Health Services & Systems Research , Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Xin Xu
- Memory Aging and Cognition Center , Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- School of Public Health and the 2nd Affiliated Hospital of Zhejiang University School of Medicine , Hangzhou 310058, China
| | - Debra Q Y Quek
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Chaoxu Qian
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Charumathi Sabanayagam
- Health Services & Systems Research , Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Christopher L H Chen
- Memory Aging and Cognition Center , Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien Yin Wong
- Health Services & Systems Research , Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Ching-Yu Cheng
- Health Services & Systems Research , Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
| | - Ecosse L Lamoureux
- Health Services & Systems Research , Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute , Singapore National Eye Centre, Singapore
- Department of Ophthalmology , The University of Melbourne, Melbourne, Australia
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14
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Bikbov MM, Kazakbaeva GM, Rakhimova EM, Rusakova IA, Fakhretdinova AA, Tuliakova AM, Panda-Jonas S, Bolshakova NI, Safiullina KR, Gizzatov AV, Ponomarev IP, Yakupova DF, Baymukhametov NE, Nikitin NA, Jonas JB. Concurrent vision and hearing impairment associated with cognitive dysfunction in a population aged 85+ years: the Ural Very Old Study. BMJ Open 2022; 12:e058464. [PMID: 35473730 PMCID: PMC9045115 DOI: 10.1136/bmjopen-2021-058464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the prevalence of vision impairment, hearing impairment and dual sensory impairment (DSI) as combination of vision and hearing impairment, in association with cognitive dysfunction in a population aged 85+ years. METHODS The cross-sectional population-based Ural Very Old Study, conducted in rural and urban Bashkortostan, Russia, between 2017 and 2020, included a detailed ocular and systemic examination with assessment of moderate to severe vision impairment (MSVI)/blindness (best-corrected visual acuity <6/18), moderate to severe hearing loss (MSHL) and cognitive function. SETTING A rural and urban area in Bashkortostan, Russia. PARTICIPANTS Out of 1882 eligible individuals aged 85+ years, 1526 (81.1%) individuals participated. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of vision, hearing and DSI and cognitive dysfunction. RESULTS The study included 731 (47.9%) individuals (mean age 88.1±2.7 years; median 87 years, range 85-98 years) with measurements of MSVI/blindness, MSHL and cognitive function. The prevalence of MSVI/blindness, MSHL, DSI and dementia were 51.8% (95% CI 48.2% to 55.5%), 33.1% (95% CI 29.7% to 36.5%), 20.5% (95% CI 17.8% to 23.5%) and 48.2% (95% CI 44.5% to 51.8%), respectively. Lower cognitive function score was associated with lower visual acuity (p<0.001) and higher hearing loss score (p=0.03), after adjusting for older age (p=0.001), rural region of habitation (p=0.003), lower educational level (p<0.001) and higher depression score (p<0.001). Higher dementia prevalence was associated with higher MSHL prevalence (OR 2.18 95% CI 1.59 to 2.98; p<0.001), higher MSVI/blindness prevalence (OR 2.09, 95% CI 1.55 to 2.81; p<0.001) and higher DSI prevalence (OR 2.80, 95% CI 1.92 to 4.07; p<0.001). CONCLUSIONS In this very old, multiethnic population from Russia, DSI (prevalence 20.5%), as compared with hearing impairment (OR 2.18) and vision impairment alone (OR 2.09), had a stronger association (OR 2.80) with dementia. The findings show the importance of hearing and vision impairment, in particular their combined occurrence, for dementia prevalence in an old population.
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Affiliation(s)
| | | | | | | | | | | | - Songhomitra Panda-Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Manheim, Germany
| | | | | | - Ainur V Gizzatov
- Ufa Eye Research Institute, Ufa, Bashkortostan, Russian Federation
| | | | - Dilya F Yakupova
- Ufa Eye Research Institute, Ufa, Bashkortostan, Russian Federation
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Manheim, Germany
- Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
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15
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Hu W, Wang Y, Wang W, Zhang X, Shang X, Liao H, Chen Y, Huang Y, Zhang X, Tang S, Yu H, Yang X, He M, Zhu Z. Association of Visual, Hearing, and Dual Sensory Impairment With Incident Dementia. Front Aging Neurosci 2022; 14:872967. [PMID: 35774111 PMCID: PMC9239339 DOI: 10.3389/fnagi.2022.872967] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The relationship between sensory impairments and the risk of dementia is inconclusive. We aim to investigate the association of visual impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI) with incident dementia. Methods The UK Biobank study recruited more than 500,000 participants aged 40-69 years across the United Kingdom. Participants with available visual acuity (VA) measurements and speech-reception-threshold (SRT) information and free of dementia at the baseline assessment were included in the analysis. VI was defined as VA worse than 0.3 LogMAR units and HI were defined as an SRT of -5.5 dB or over. DSI was defined as the presence of both VI and HI. Incident dementia was identified through linked data to primary care or hospital admission records and death registries. Multivariable Cox proportional hazard regression models were used to examine the association of VI, HI, and DSI with incident dementia. Results Among 113,511 participants (mean age: 56.8 ± 8.09 years, female: 54.4%), a total number of 1,135 (1.00%) cases of incident dementia were identified during a median follow up period of 11.1 years [interquartile range (IQR): 10.9-11.4 years]. The incidence of dementia showed significant differences among the non-sensory impairment (NSI) group, VI-only group, HI-only group, and DSI group (p < 0.001). After adjusting for demographic, lifestyle, health, and genetic factors, isolated VI (HR = 1.50, 95% CI: 1.06-2.12, p = 0.023), isolated HI (HR = 1.42, 95% CI:1.20-1.69, p < 0.001), and DSI (HR = 1.82, 95% CI: 1.10-3.00, p = 0.020) were independently associated with higher risks of incident dementia. Conclusions Visual, hearing, and dual sensory impairments were associated with an increased risk of developing dementia, suggesting that visual and hearing impairments are modifiable risk factors that can be targeted to prevent dementia.
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Affiliation(s)
- Wenyi Hu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Yueye Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xinyu Zhang
- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xianwen Shang
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
| | - Huan Liao
- Neural Regeneration Group, Institute of Reconstructive Neurobiology, University of Bonn, Bonn, Germany
| | - Yifan Chen
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Yu Huang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Xueli Zhang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Shulin Tang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Xiaohong Yang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Mingguang He
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhuoting Zhu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
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16
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Zhu Z, Hu W, Liao H, Tan Z, Chen Y, Shi D, Shang X, Zhang X, Huang Y, Yu H, Wang W, He M, Yang X. Association of visual impairment with risk for future Parkinson's disease. EClinicalMedicine 2021; 42:101189. [PMID: 34805812 PMCID: PMC8585627 DOI: 10.1016/j.eclinm.2021.101189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Although visual dysfunction is one of the most common non-motor symptoms among patients with Parkinson's disease (PD), it is not known whether visual impairment (VI) predates the onset of clinical PD. Therefore, we aim to examine the association of VI with the future development of PD in the UK Biobank Study. METHODS The UK Biobank Study is one of the largest cohort studies of health, enrolling over 500,000 participants aged 40-69 years between 2006 and 2010 across the UK. VI was defined as a habitual distance visual acuity (VA) worse than 0·3 logarithm of the minimum angle of resolution (LogMAR) in the better-seeing eye. Incident cases of PD were determined by self report data, hospital admission records or death records, whichever came first. Multivariable Cox proportional hazard regression models were used to investigate the association between VI and the risk of incident PD. FINDINGS A total of 117,050 participants were free of PD at the baseline assessment. During the median observation period of 5·96 (IQR: 5·77-6·23) years, PD occurred in 222 (0·19%) participants. Visually impaired participants were at a higher risk of developing PD than non-VI participants (p < 0·001). Compared with the non-VI group, the adjusted hazard ratio was 2·28 (95% CI 1·29-4·05, p = 0·005) in the VI group. These results were consistent in the sensitivity analysis, where incident PD cases diagnosed within one year after the baseline assessment were excluded. INTERPRETATION This cohort study found that VI was associated with an increased risk of incident PD, suggesting that VI may serve as a modifiable risk factor for prevention of future PD.
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Key Words
- Ageing
- BMI, body mass index
- CI, confidence intervals
- HR, hazard ratios
- IQR, interquartile range
- LogMAR, logarithm of the minimum angle of resolution
- NHS, National Health Service
- PD, Parkinson's disease
- PHQ-2, Patient Health Questionnaire-2
- PPV, positive predictive value
- Parkinson's disease
- SD, standard deviations
- VA, visual acuity
- VI, visual impairment
- Visual impairment
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Affiliation(s)
- Zhuoting Zhu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Wenyi Hu
- Shanghai Jiaotong University, Shanghai, China
- Centre for Eye Research, University of Melbourne, East Melbourne, Victoria, Australia
| | - Huan Liao
- Neural Regeneration Group, Institute of Reconstructive Neurobiology, University of Bonn, Bonn, Germany
| | - Zachary Tan
- Centre for Eye Research, University of Melbourne, East Melbourne, Victoria, Australia
| | - Yifan Chen
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Danli Shi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xianwen Shang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Xueli Zhang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Yu Huang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Corresponding authors.
| | - Mingguang He
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
- Centre for Eye Research, University of Melbourne, East Melbourne, Victoria, Australia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Centre for Eye Research, University of Melbourne, East Melbourne, Victoria, Australia
| | - Xiaohong Yang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
- Corresponding authors.
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17
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Chiang MF. The 2021 National Eye Institute Strategic Plan-Relating Vision to Health and Quality of Life. JAMA Ophthalmol 2021; 139:1263-1265. [PMID: 34724031 DOI: 10.1001/jamaophthalmol.2021.4774] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Michael F Chiang
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
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18
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19
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Ehrlich JR, Deal JA, Swenor BK. Re: Pershing et al.: Bidirectional association between visual impairment and dementia among older adults in the United States over time (Ophthalmology. 2021;128:1276-1283). Ophthalmology 2021; 129:e33. [PMID: 34756774 DOI: 10.1016/j.ophtha.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/06/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland; The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, Maryland
| | - Bonnielin K Swenor
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland; Department of Ophthalmology, Johns Hopkins University, Baltimore, Maryland; The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, Maryland
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