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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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Aubin G, Phillips N, Jaiswal A, Johnson AP, Joubert S, Bachir V, Kehayia E, Wittich W. Visual and cognitive functioning among older adults with low vision before vision rehabilitation: A pilot study. Front Psychol 2023; 14:1058951. [PMID: 37034930 PMCID: PMC10075203 DOI: 10.3389/fpsyg.2023.1058951] [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: 10/19/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction The occurrence of age-related vision changes is inevitable. However, some of these changes can become pathological. Research indicates that vision and hearing loss is correlated with age-related cognitive decline, and with a higher risk of developing dementia due to Alzheimer's disease. Low vision rehabilitation could possibly be a protective factor against cognitive decline, as it provides the clients with compensatory strategies to overcome their visual deficits. Objectives and hypothesis The aim of this pilot study was to assess correlations between visual and cognitive functions in older adults referred for low vision rehabilitation. We hypothesized that more severe impairment of visual acuity and contrast sensitivity would be correlated with more advanced levels of cognitive impairment. The second objective was to examine which of these correlations would remain significant once established variables that influence cognition are statistically removed (e.g., age, education). Methods Thirty-eight older adults (age range: 66-97 years old) with a visual impairment (acuity <20/70) were recruited before the onset of their low vision rehabilitation. They underwent vision (reading acuity, reading speed, contrast sensitivity), hearing (audiogram, speech-in-noise perception) and cognitive (global cognition, memory, executive functions) testing, and demographic information was obtained. Results and discussion Correlations among global cognition and visual aid use, memory and reading speed, memory and contrast sensitivity, memory, and visual aid use, and between executive functions and contrast sensitivity were significant. Correlations between contrast sensitivity and memory, as well as between global cognition and visual aid use remained significant after controlling for age and education. The present study is relevant to clinicians who are assessing the cognitive status of older adults, such as neuropsychologists, because it highlights the importance of considering low vision when administering neuropsychological tests, especially to persons who have not yet received rehabilitation for their visual impairment.
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Affiliation(s)
- Gabrielle Aubin
- School of Optometry, Université de Montréal, Montréal, QC, Canada
| | - Natalie Phillips
- Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Atul Jaiswal
- School of Optometry, Université de Montréal, Montréal, QC, Canada
| | | | - Sven Joubert
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Vanessa Bachir
- School of Optometry, Université de Montréal, Montréal, QC, Canada
| | - Eva Kehayia
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montréal, QC, Canada
- Department of Psychology, Concordia University, Montréal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
- *Correspondence: Walter Wittich,
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Trott M, Smith L, Veronese N, Pizzol D, Barnett Y, Gorely T, Pardhan S. Eye disease and mortality, cognition, disease, and modifiable risk factors: an umbrella review of meta-analyses of observational studies. Eye (Lond) 2022; 36:369-378. [PMID: 34272511 PMCID: PMC8807837 DOI: 10.1038/s41433-021-01684-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 06/22/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023] Open
Abstract
Globally, 2.2 billion people live with some form of vision impairment and/or eye disease. To date, most systematic reviews examining associations have focused on a single eye disease and there is no systematic evaluation of the relationships between eye diseases and diverse physical and mental health outcomes. Moreover, the strength and reliability of the literature is unclear. We performed an umbrella review of observational studies with meta analyses for any physical and/or mental comorbidities associated with eye disease. For each association, random-effects summary effect size, heterogeneity, small-study effect, excess significance bias and 95% prediction intervals were calculated, and used to grade significant evidence from convincing to weak. 34 studies were included covering 58 outcomes. No outcomes yielded convincing evidence, six outcomes yielded highly suggestive results (cataract positively associated with type 2 diabetes, open-angled glaucoma positively associated with myopia and diabetes, diabetic retinopathy positively associated with cardiovascular disease and cardiovascular mortality, and retinopathy of prematurity positively associated with chorioamnionitis), eight outcomes yielded suggestive results (diabetic retinopathy positively associated with all-cause mortality and depression, diabetic macular oedema positively associated with dyslipidaemia, cataract positively associated with gout, nuclear sclerosis positively associated with all-cause mortality, open angled glaucoma positively associated with migraine and hypertension, and age-related macular degeneration positively associated with diabetes), and 18 outcomes yielded weak evidence. Results show highly suggestive or suggestive evidence for associations between several types of eye diseases with several comorbid outcomes. Practitioners and public health policies should note these findings when developing healthcare policies.
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Affiliation(s)
- Mike Trott
- grid.5115.00000 0001 2299 5510Vision and Eye Research Institute (VERI), School of Medicine, Anglia Ruskin University, Cambridge, UK ,grid.5115.00000 0001 2299 5510The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Lee Smith
- grid.5115.00000 0001 2299 5510The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Nicola Veronese
- grid.418879.b0000 0004 1758 9800National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy ,grid.10776.370000 0004 1762 5517University of Palermo, Department of Geriatrics, Palermo, Italy
| | - Damiano Pizzol
- Italian Agency for Development Cooperation (Khartoum), Khartoum, Sudan
| | - Yvonne Barnett
- grid.5115.00000 0001 2299 5510School of Life Sciences, Anglia Ruskin University, Cambridge, UK
| | - Trish Gorely
- grid.23378.3d0000 0001 2189 1357Department of Nursing and Midwifery, University of the Highlands and Islands, Centre for Health Sciences, Inverness, UK
| | - Shahina Pardhan
- grid.5115.00000 0001 2299 5510Vision and Eye Research Institute (VERI), School of Medicine, Anglia Ruskin University, Cambridge, UK
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Aubin G, Elalouf K, Hogan M, Altschuler A, Murphy KJ, Wittich W. Usability and Accessibility of the ArtontheBrain ™ Virtual Recreation Activity for Older Adults With Low Vision Due to Age-Related Macular Degeneration. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580211067446. [PMID: 34985349 PMCID: PMC8743942 DOI: 10.1177/00469580211067446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Experiencing visual art can inspire, be an overall positive leisure activity, and has been linked to improved cognition, especially in older adults. Access to artwork in a museum environment can comprise a variety of barriers, including difficulties linked to its visual experience for persons that are visually impaired. The present study explored the barriers and facilitators experienced by 15 older adults (age 65 to 93) living with age-related macular degeneration when using an iPad to access ArtontheBrain™, a virtual art museum recreation experience created by members of this team. Using the Concurrent Think Aloud method, participants were asked to continuously comment on their experiences with the application while being audio/video recorded. Indeed, codes were determined by identifying frequently stated and emphasized ideas or behaviors of participants using the ArtontheBrain™ application. Transcripts underwent thematic analysis and indicated that the main access barriers were linked to control of the contrast, magnification, and the tactile interface on the tablet device. The learn and play activities as well as the text-to-speech feature were identified as facilitators for ArtontheBrain™ engagement. The present findings should also be considered in the larger context of application development, as this study provides insight pertaining to the needs of low vision individuals regarding usability and accessibility.
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Affiliation(s)
- Gabrielle Aubin
- School of Optometry, Université de Montréal, Montréal, QC, Canada
| | - Karine Elalouf
- School of Optometry, Université de Montréal, Montréal, QC, Canada
| | - Mariah Hogan
- School of Optometry, Université de Montréal, Montréal, QC, Canada
| | | | - Kelly J. Murphy
- Baycrest Health Sciences, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montréal, QC, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, QC, Canada
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Murphy C, Johnson AP, Koenekoop RK, Seiple W, Overbury O. The Relationship Between Cognitive Status and Known Single Nucleotide Polymorphisms in Age-Related Macular Degeneration. Front Aging Neurosci 2020; 12:586691. [PMID: 33178008 PMCID: PMC7596199 DOI: 10.3389/fnagi.2020.586691] [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: 07/23/2020] [Accepted: 09/15/2020] [Indexed: 11/13/2022] Open
Abstract
Recent literature has reported a higher occurrence of cognitive impairment among individuals with Age-related Macular Degeneration (AMD) compared to older adults with normal vision. This pilot study explored potential links between single nucleotide polymorphisms (SNPs) in AMD and cognitive status. Individuals with AMD (N = 21) and controls (N = 18) were genotyped for the SNPs CFHY402H, ARMS2A69S and FADS1 rs174547. Cognitive status was evaluated using the Montreal Cognitive Assessment. The two groups differed significantly on which subscales were most difficult. The control group had difficulty with delayed recall while those with AMD had difficulty on delayed recall in addition to abstraction and orientation. Homozygous carriers of the FADS1 rs174547 SNP had significantly lower scores than heterozygotes or non-carriers on the MoCA. The results suggest that the FADS1 SNP may play a role in visual impairment/cognitive impairment comorbidity as reflected in the poorer cognitive scores among homozygotes with AMD compared to those carrying only one, or no copies of the SNP.
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Affiliation(s)
- Caitlin Murphy
- Low Vision Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
- Concordia Vision Labs, Department of Psychology, Concordia University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)/Centre de Réadaptation Lethbridge-Layton-Mackay du Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Ouest-de-l’Ile-de-Montréal (CIUSSS) du Centre-Ouest-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - Aaron P. Johnson
- Concordia Vision Labs, Department of Psychology, Concordia University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)/Centre de Réadaptation Lethbridge-Layton-Mackay du Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Ouest-de-l’Ile-de-Montréal (CIUSSS) du Centre-Ouest-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - Robert K. Koenekoop
- Paediatric Surgery and Human Genetics and Ophthalmology, Faculty of Medicine, McGill University Health Centre, Montreal QC, Canada
| | - William Seiple
- Arlene R. Gordon Research Institute, Lighthouse Guild, New York, NY, United States
- School of Medicine, New York University, New York, NY, United States
| | - Olga Overbury
- Low Vision Lab, School of Optometry, University of Montreal, Montreal, QC, Canada
- Lady Davis Institute of Medical Research, Montreal, QC, Canada
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Zuo X, Zhuang J, Chen NK, Cousins S, Cunha P, Lad EM, Madden DJ, Potter G, Whitson HE. Relationship between neural functional connectivity and memory performance in age-related macular degeneration. Neurobiol Aging 2020; 95:176-185. [PMID: 32829250 DOI: 10.1016/j.neurobiolaging.2020.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
Age-related macular degeneration (AMD) has been linked to memory deficits, with no established neural mechanisms. We collected resting-state brain functional magnetic resonance imaging and standardized verbal recall tests from 42 older adults with AMD and 41 age-matched controls. We used seed-based whole brain analysis to quantify the strength of functional connectivity between hubs of the default mode network and a network of medial temporal regions relevant for memory. Our results indicated neither memory performance nor network connectivity differed by AMD status. However, the AMD participants exhibited stronger relationships than the controls between memory performance and connectivity from the memory network hub (left parahippocampal) to 2 other regions: the left temporal pole and the right superior/middle frontal gyri. Also, the connectivity between the medial prefrontal cortex and posterior cingulate cortex of default mode network correlated more strongly with memory performance in AMD compared to control. We concluded that stronger brain-behavior correlation in AMD may suggest a role for region-specific connectivity in supporting memory in the context of AMD.
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Affiliation(s)
- Xintong Zuo
- Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA; Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Jie Zhuang
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA
| | - Nan-Kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA
| | - Scott Cousins
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - Priscila Cunha
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA; Duke University School of Medicine, Durham, NC, USA
| | - Eleonora M Lad
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - David J Madden
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Guy Potter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Heather E Whitson
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA; Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA; Department of Medicine (Geriatrics), Duke University Medical Center, Durham, NC, USA; Geriatrics Research Education & Clinical Center, Durham VA Medical Center, Durham, NC, USA.
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Aldebert G, Faillie JL, Hillaire-Buys D, Mura T, Carrière I, Delcourt C, Creuzot-Garcher C, Villain M, Daien V. Association of Anticholinergic Drug Use With Risk for Late Age-Related Macular Degeneration. JAMA Ophthalmol 2019; 136:770-778. [PMID: 29800005 DOI: 10.1001/jamaophthalmol.2018.1719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Importance Amyloid-β is a major component of retinal drusen, the primary lesions of age-related macular degeneration (AMD), and autopsy and animal models suggested that anticholinergic drug (ACD) use increased brain amyloid-β deposition. Objective To investigate the association between exposure to ACDs and late AMD (features of neovascular AMD or geographic atrophy of the retinal pigment epithelium in at least 1 eye). Design, Setting and Participants A multicenter case-control study in 4 French ophthalmologic centers comprising 200 cases with late AMD and 200 controls enrolled from July 2016 to June 2017. Exposures Exposure to at least 3 months of ACDs started before AMD diagnosis was recorded during a specific interview. A dose-effect association with cumulative exposure duration and Anticholinergic Burden Score was explored. The association between ACD exposure and AMD was assessed by multivariate logistic regression analysis adjusted for age, sex, smoking status, family history of AMD, alcohol consumption, and use of anticoagulant and anti-inflammatory drugs. Odds ratios (ORs) and 95% confidence intervals were estimated. Main Outcomes and Measures Association between exposure to ACDs and late AMD. Results Among case participants, the mean (SD) age was 74.8 (9.2) years, 129 (64.5%) were women, 192 (96%) were white, 65 (32.5%) had geographic atrophy, 135 (67.5%) had neovascular AMD, 116 (58%) had unilateral AMD, and 84 (42%) had bilateral AMD. Among control participants, the mean (SD) age was 75.5 (7.2) years, with 116 (58%) women and 187 (93.5%) white participants. Twenty-six cases (13%) and 10 controls (5%) were exposed to ACDs throughout life for at least 3 months before AMD onset. Risk of AMD was increased with ever exposure to ACDs (adjusted OR [aOR], 2.84; 95% CI, 1.33-6.06; P = .007), high Anticholinergic Burden Score (≥3) (aOR, 6.42; 95% CI, 1.38-29.92; P = .02), and longest cumulative exposure to ACD (≥15 years) (aOR, 5.88; 95% CI, 1.22-28.31; P = .03). Conclusions and Relevance Risk of late AMD may be increased with at least 3 months' use of ACDs. A dose-effect association was suggested by a greater association with prolonged use and high Anticholinergic Burden Score. Further studies, in particular those with longitudinal design, are needed to confirm this association.
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Affiliation(s)
- Gauthier Aldebert
- Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier, France
| | - Jean-Luc Faillie
- Department of Medical Pharmacology and Toxicology, Lapeyronie Hospital, Montpellier, France
| | | | - Thibault Mura
- Department of Epidemiologic and Clinical Reserch, La Colombière Hospital, Montpellier, France.,Institut National de la Santé et de la Recherche Médicale, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Isabelle Carrière
- Institut National de la Santé et de la Recherche Médicale, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Cécile Delcourt
- University Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France
| | | | - Max Villain
- Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier, France
| | - Vincent Daien
- Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier, France.,Institut National de la Santé et de la Recherche Médicale, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
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Yu SS, Tang X, Ho YS, Chang RCC, Chiu K. Links between the Brain and Retina: The Effects of Cigarette Smoking-Induced Age-Related Changes in Alzheimer's Disease and Macular Degeneration. Front Neurol 2016; 7:119. [PMID: 27512384 PMCID: PMC4961692 DOI: 10.3389/fneur.2016.00119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 07/08/2016] [Indexed: 12/30/2022] Open
Affiliation(s)
- Sha Sha Yu
- Laboratory of Retina Brain Research, Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Tianjin Medical University, Tianjin, China; Tianjin Eye Hospital, Tianjin, China
| | - Xin Tang
- Tianjin Eye Hospital , Tianjin , China
| | - Yuen-Shan Ho
- Faculty of Health and Social Sciences, School of Nursing, The Hong Kong Polytechnic University , Hong Kong , China
| | - Raymond Chuen-Chung Chang
- Laboratory of Neurodegenerative Diseases, LKS Faculty of Medicine, School of Biomedical Sciences, The University of Hong Kong, Hong Kong, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong, China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Kin Chiu
- Laboratory of Retina Brain Research, Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong, China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
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