Spierer Oriel, Fischer Naomi, Barak Adiel, Belkin Michael
From the Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine (OS, NF, AB); and Ophthalmic Technologies Laboratory, Goldschleger Eye Research Institute, Tel Aviv University, Tel Hashomer, Israel (MB).
Medicine (Baltimore). 2016 Jan;95(3):e2423. doi: 10.1097/MD.0000000000002423.
The correlation between vision and cognition is not fully understood. Visual impairment in the elderly has been associated with impaired cognitive function, dementia, and Alzheimer disease. The aim was to study the correlation between near visual acuity (VA), refraction, and cognitive state in an elderly population.Subjects ≥75 years were enrolled in this cross-sectional study. Refraction and near VA was tested. Cognitive function was evaluated with a version of the mini-mental state examination for the visually impaired (MMSE-blind). The eye with better VA and no cataract or refractive surgery was analyzed.One-hundred ninety subjects (81.6 ± 5.1 years, 69.5% female) were included. Good VA (≤J3) was associated with high MMSE-blind (>17) (OR = 3.18, 95% CI = 1.57-6.43, P = 0.001). This remained significant adjusting for sex, age, and years of education. Wearing reading glasses correlated significantly with high MMSE-blind after adjustment for sex and age (OR = 2.14, 95% CI = 1.16-3.97, P = 0.016), but reached borderline significance after adjustment for education. There was a trend toward correlation between myopia and better MMSE-blind (r = -0.123, P = 0.09, Pearson correlation).Good VA and wearing glasses seem to correlate with better cognitive function. Reading glasses can serve as a protective factor against cognitive deterioration associated with sensory (visual) deprivation in old age. The association between myopia and cognition requires further investigation.
视力与认知之间的关联尚未完全明确。老年人视力障碍与认知功能受损、痴呆及阿尔茨海默病有关。本研究旨在探讨老年人群中近视力（VA）、屈光状态与认知状态之间的相关性。
本横断面研究纳入了年龄≥75岁的受试者。检测了屈光状态和近视力。采用针对视力受损者的简易精神状态检查表（MMSE-blind）评估认知功能。分析视力较好且无白内障或未接受屈光手术的眼睛。
共纳入190名受试者（年龄81.6±5.1岁，女性占69.5%）。良好的视力（≤J3）与较高的MMSE-blind评分（>17）相关（OR=3.18，95%CI=1.57-6.43，P=0.001）。在对性别、年龄和受教育年限进行校正后，该相关性仍然显著。在对性别和年龄进行校正后，佩戴阅读眼镜与较高的MMSE-blind评分显著相关（OR=2.14，95%CI=1.16-3.97，P=0.016），但在对受教育程度进行校正后达到临界显著性。近视与较好的MMSE-blind评分之间存在一定的相关性趋势（r=-0.123，P=0.09，Pearson相关性）。
良好的视力和佩戴眼镜似乎与较好的认知功能相关。阅读眼镜可作为预防老年时与感觉（视觉）剥夺相关的认知衰退的保护因素。近视与认知之间的关联需要进一步研究。
