Ageing effects on the attentional capacities and working memory of people who are blind

How ageing and blindness affect egocentric and allocentric spatial memory

Egocentric (subject-to-object) and allocentric (object-to-object) spatial reference frames are fundamental for representing the position of objects or places around us. The literature on spatial cognition in blind people has shown that lack of vision may limit the ability to represent spatial information in an allocentric rather than egocentric way. Furthermore, much research with sighted individuals has reported that ageing has a negative impact on spatial memory. However, as far as we know, no study has assessed how ageing may affect the processing of spatial reference frames in individuals with different degrees of visual experience. To fill this gap, here we report data from a cross-sectional study in which a large sample of young and elderly participants (160 participants in total) who were congenitally blind (long-term visual deprivation), adventitiously blind (late onset of blindness), blindfolded sighted (short-term visual deprivation) and sighted (full visual availability) performed a spatial memory task that required egocentric/allocentric distance judgements with regard to memorised stimuli. The results showed that egocentric judgements were better than allocentric ones and above all that the ability to process allocentric information was influenced by both age and visual status. Specifically, the allocentric judgements of congenitally blind elderly participants were worse than those of all other groups. These findings suggest that ageing and congenital blindness can contribute to the worsening of the ability to represent spatial relationships between external, non-body-centred anchor points.

The Bidirectional Relationship between Vision and Cognition: A Systematic Review and Meta-analysis

TOPIC

Visual impairment (VI) and cognitive impairment (CIM) are prevalent age-related conditions that impose substantial burden on the society. Findings on the hypothesized bidirectional association of VI and CIM remains equivocal. Hence, we conducted a systematic review and meta-analysis to examine this bidirectional relationship.

CLINICAL RELEVANCE

Sixty percent risk of CIM has not been well elucidated in the literature. A bidirectional relationship between VI and CIM may support the development of strategies for early detection and management of risk factors for both conditions in older people.

METHODS

PubMed, Embase, and Cochrane Central registers were searched systematically for observational studies, published from inception until April 6, 2020, in adults 40 years of age or older reporting objectively measured VI and CIM assessment using clinically validated cognitive screening tests or diagnostic evaluation. Meta-analyses on cross-sectional and longitudinal associations between VI and CIM outcomes (any CIM assessed using screening tests and clinically diagnosed dementia) were examined. Random effect models were used to generate pooled odds ratios (ORs) and 95% confidence intervals (CIs). We also examined study quality, publication bias, and heterogeneity.

RESULTS

Forty studies were included (n = 47 913 570). Meta-analyses confirmed that persons with VI were more likely to have CIM, with significantly higher odds of: (1) any CIM (cross-sectional: OR, 2.38 [95% CI, 1.84-3.07]; longitudinal: OR, 1.66 [95% CI, 1.46-1.89]) and (2) clinically diagnosed dementia (cross-sectional: OR, 2.43 [95% CI, 1.48-4.01]; longitudinal: OR, 2.09 [95% CI, 1.37-3.21]) compared with persons without VI. Significant heterogeneity was explained partially by differences in age, sex, and follow-up duration. Also, some evidence suggested that individuals with CIM, relative to cognitively intact persons, were more likely to have VI, with most articles (8/9 [89%]) reporting significantly positive associations; however, meta-analyses on this association could not be conducted because of insufficient data.

DISCUSSION

Overall, our work suggests that VI is a risk factor of CIM, although further work is needed to confirm the association of CIM as a risk factor for VI. Strategies for early detection and management of both conditions in older people may minimize individual clinical and public health consequences.