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Mohammed Z, Kee QT, Fadzil NM, Abd Rahman MH, Din NC, Mariappan V, Shahar S. Association between vision and cognitive function among community-dwelling older adults in Selangor, Malaysia. Int J Ophthalmol 2023; 16:115-120. [PMID: 36659949 PMCID: PMC9815982 DOI: 10.18240/ijo.2023.01.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022] Open
Abstract
AIM To determine the association between distance and near visual acuity (VA) and cognitive function among older adults in Selangor, Malaysia. METHODS A total of 230 older adults (age ≥60y) participated in this study. Habitual distance and near VA were measured using the Early Treatment Diabetic Retinopathy Study Chart and Lighthouse Near Visual Acuity Chart, respectively. Global cognitive function was assessed using the Mini-Mental State Examination (M-MSE) and the Malay language version of the Montreal Cognitive Assessment (M-MoCA). Digit Symbol (DS) subtest was used to measure information processing. RESULTS No significant association was observed between vision and M-MSE and M-MoCA scores. However, poor distance and near VA were found to be significantly associated with low DS scores [distance VA: β=-0.01, R 2=0.1, P=0.02; odds ratio (OR)=2.84, 95% confidence interval (CI), 1.10-7.33, P=0.03; near VA: β=-0.05, R 2=0.08, P=0.00; OR=3.32, 95%CI, 1.28-8.59, P=0.01]. CONCLUSION Poor vision is associated with a decline in information processing in older adults and substantiates the importance of preserving good vision in maintaining cognitive function.
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Affiliation(s)
- Zainora Mohammed
- Programme of Optometry and Vision Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Qiu-Ting Kee
- Programme of Optometry and Vision Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Norliza Mohamad Fadzil
- Programme of Optometry and Vision Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Mohd Harimi Abd Rahman
- Programme of Optometry and Vision Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre for Rehabilitation and Special Needs Study, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Vanitha Mariappan
- Center of Toxicology and Risk Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Programme of Dietetic, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia.
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Gómez-Soria I, Iguacel I, Aguilar-Latorre A, Peralta-Marrupe P, Latorre E, Zaldívar JNC, Calatayud E. Cognitive stimulation and cognitive results in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 104:104807. [PMID: 36116285 DOI: 10.1016/j.archger.2022.104807] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE The lack of cognitive activity accelerates age cognitive decline. Cognitive stimulation (CS) tries to enhance cognitive functioning. The purpose of this systematic review and meta-analysis was to evaluate the effects of CS on cognitive outcomes (general cognitive functioning and specific cognitive domains) in older adults (aged 65 years or older, cognitively healthy participants, or with mild cognitive impairment, or dementia). METHODS PubMed, Scopus and Web of Science databases were examined from inception to October 2021. A total of 1,997 studies were identified in these databases, and. 33 studies were finally included in the systematic review and the meta-analysis. Raw means and standard deviations were used for continuous outcomes. Publication bias was examined by Egger's Regression Test for Funnel Plot Asymmetry and the quality assessment tools from the National Institutes of Health. RESULTS CS significantly improves general cognitive functioning (mean difference=MD = 1.536, 95%CI, 0.832 to 2.240), memory (MD = 0.365, 95%CI, 0.300 to 0.430), orientation (MD = 0.428, 95%CI, 0.306 to 0.550), praxis (MD = 0.278, 95%CI, 0.094 to 0.462) and calculation (MD = 0.228, 95%CI, 0.112 to 0.343). CONCLUSION CS seems to increase general cognitive functioning, memory, orientation, praxis, and calculation in older adults.
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Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.
| | - Isabel Iguacel
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain.
| | | | - Patricia Peralta-Marrupe
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Eva Latorre
- Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan Nicolás Cuenca Zaldívar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, Spain; Primary Health Center "El Abajon", 28231 Las Rozas de Madrid, Spain
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
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Su KC, Cheng HM, Chu Y, Lu FC, Tsai LH, Cheng CY. Correlating Ocular Physiology and Visual Function with Mild Cognitive Loss in Senior Citizens in Taiwan. J Clin Med 2022; 11:2624. [PMID: 35566750 PMCID: PMC9103053 DOI: 10.3390/jcm11092624] [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: 03/07/2022] [Revised: 04/05/2022] [Accepted: 05/05/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose: The transition of Taiwan from an aging to a super-aging society has come with a cost as more elderly now suffer from cognitive impairment. The main purpose of our study was to investigate if early detection can be developed so that timely intervention can be instituted. We analyzed the correlation of cognitive function with ocular physiology and visual functions between senior citizens aged 60 years or older in Taiwan. Methods: Thirty-six healthy subjects were recruited for the study. Addenbrooke's cognitive examination III (ACE-III), binocular functions (including objective and subjective refraction, distance and near dissociated phoria, stereopsis, contrast sensitivity, adult developmental eye movement (ADEM), and ocular physiology (by using optical coherence tomography, OCT, and macular pigment measurement, MPS) were performed, and the data were analyzed via independent t-test, chi-square test, Pearson correlation, linear regression, and ROC (receiver operating characteristic) curve. Results: Data analysis showed that (1) patients with poor eye movement had a strong correlation with the total score and all dimensions of cognitive functions, (2) the thickness of the macula had a strong correlation with attention and memory, and (3) patients with poor eye movement and poor stereopsis in combination with thinner inferior macula appeared to have lower cognitive abilities. Discussion and Conclusions: Cognitive dysfunction is not readily identified during the early stage of cognitive decline. The use of simple and inexpensive ADEM or stereopsis test and comparing the OCT results that are popular in optometry clinics for reference can be diagnostic in identifying patients with mild cognitive impairments. With the combined use of macular pigment density or retinal thickness measurements, it was possible to effectively predict the early degradation of cognition.
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Affiliation(s)
- Kuo-Chen Su
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
- Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan; (Y.C.); (F.-C.L.)
| | - Hong-Ming Cheng
- Department of Optometry, Asia University, Taichung 413, Taiwan;
| | - Yu Chu
- Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan; (Y.C.); (F.-C.L.)
| | - Fang-Chun Lu
- Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan; (Y.C.); (F.-C.L.)
| | - Lung-Hui Tsai
- Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan; (Y.C.); (F.-C.L.)
| | - Ching-Ying Cheng
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
- Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan; (Y.C.); (F.-C.L.)
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Chang CW, Su KC, Lu FC, Cheng HM, Cheng CY. Visual Function and Visual Perception among Senior Citizens with Mild Cognitive Impairment in Taiwan. Healthcare (Basel) 2021; 10:healthcare10010020. [PMID: 35052184 PMCID: PMC8775582 DOI: 10.3390/healthcare10010020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/09/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: With the benefits of advanced medical technology, Taiwan has gradually changed from an aged society to a super-aged society. According to previous studies, the prevalence rate of mild cognitive impairment (MCI) over the age of 60 is 15% to 20%. Therefore, the main purpose of our study was to analyze the correlation of cognitive function with visual function (specifically, binocular vision and visual perception) in Taiwanese volunteers aged 60 years or older. Methods: Thirty-six healthy participants who were not taking psychiatric medications and who had not been diagnosed with any retinal or optic nerve diseases were enrolled. Addenbrooke’s cognitive examination III (ACE-III), binocular visual function, and visual perception evaluation were performed, and the data analyzed statistically by t-test, χ2, linear regression, and MANOVA. Results: Cognitive function was closely correlated with visual function and visual perception; the horizontal adjustment time of binocular eye movement, stereopsis, the motor-free visual perception test-4 (MVPT-4), and peripheral awareness actually displayed higher explanatory power in predicting cognitive function. In addition, various interactive parameters between visual function and visual perception were found to affect specific aspects of ACE-III. Discussion: Our study revealed that there was a close correlation of cognitive function with visual function; as such, it may be possible to predict visual function deficits in patients with mild cognitive impairment.
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Affiliation(s)
- Chi-Wu Chang
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan; (C.-W.C.); (K.-C.S.)
| | - Kuo-Chen Su
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan; (C.-W.C.); (K.-C.S.)
- Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan;
| | - Fang-Chun Lu
- Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan;
| | - Hong-Ming Cheng
- Department of Optometry, Asia University, Taichung 413, Taiwan;
| | - Ching-Ying Cheng
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan; (C.-W.C.); (K.-C.S.)
- Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan;
- Correspondence: ; Tel.: +886-4-2473-0022
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Gómez-Soria I, Ferreira C, Oliván Blazquez B, Magallón Botaya RM, Calatayud E. Short-term memory, attention, and temporal orientation as predictors of the cognitive impairment in older adults: A cross-sectional observational study. PLoS One 2021; 16:e0261313. [PMID: 34928983 PMCID: PMC8687627 DOI: 10.1371/journal.pone.0261313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
Late-life cognitive decline ranges from the mildest cases of normal, age-related change to mild cognitive impairment to severe cases of dementia. Dementia is the largest global burden for the 21st century welfare and healthcare systems. The aim of this study was to analyze the neuropsychological constructs (temporal orientation (TO), spatial orientation (SO), fixation memory (FM), attention (A), calculation (C), short-term memory (STM), language (L), and praxis (P)), semantic fluency, level of functionality, and mood that reveal the greatest deficit in the different stages ranging from normal cognition (NC) to cognitive impairment in older adults in a primary healthcare setting. The study included 337 participants (102 men, 235 women), having a mean age of 74 ± 6 years. According to their scores on the Spanish version of the Mini-Mental State Examination (MEC-35), subjects were divided into 4 groups: no deterioration (ND) (score 32-35), subtle cognitive impairment (SCI) (score 28-31), level deterioration (LD) (score 24-27) and moderate deterioration (MD) (score 20-23). The ND group revealed significant differences in TO, STM, C, A, L, P, and S-T as compared to the other groups. The MD group (in all the neuropsychological constructs) and the ND and SCI groups showed significant differences on the Yesavage geriatric depression scale (GDS-15). All except the FM neuropsychological construct were part of the MEC-35 prediction model and all of the regression coefficients were significant for these variables in the model. Furthermore, the highest average percentage of relative deterioration occurs between LD and MD and the greatest deterioration is observed in the STM for all groups, including A and TO for the LD and MD groups. Based on our findings, community programs have been implemented that use cognitive stimulation to prevent cognitive decline and to maintain the neuropsychological constructs.
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Affiliation(s)
- Isabel Gómez-Soria
- Faculty of Health Sciences, Department of Physiatry and Nursing,
University of Zaragoza, Zaragoza, Spain
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
| | - Chelo Ferreira
- Faculty of Veterinary Sciences, Department of Applied Mathematics and
IUMA, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván Blazquez
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
- Faculty of Social and Labor Sciences, Department of Psychology and
Sociology, University of Zaragoza, Zaragoza, Spain
| | - Rosa Mª Magallón Botaya
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
- Faculty of Medicine, Department of Medicine, Psychiatry and Dermatology,
University of Zaragoza, Zaragoza, Spain
| | - Estela Calatayud
- Faculty of Health Sciences, Department of Physiatry and Nursing,
University of Zaragoza, Zaragoza, Spain
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
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