Miyata Kimie, Yoshikawa Tadanobu, Morikawa Masayuki, Mine Masashi, Okamoto Nozomi, Kurumatani Norio, Ogata Nahoko
Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan.
Mie Prefectural Mental Care Center, Tsu, Mie, Japan.
PLoS One. 2018 Feb 20;13(2):e0192677. doi: 10.1371/journal.pone.0192677. eCollection 2018.
To determine whether there is a significant association between prior cataract surgery and cognitive function in an elderly Japanese cohort.
Nara Medical University, Nara, Japan.
The Fujiwara-kyo Eye Study was a cross-sectional epidemiological study.
The subjects were ≥ 68-years who lived in the Nara Prefecture and responded to recruitment notices. All of the subjects received comprehensive ophthalmological examinations, and answered questionnaires on their socio-demographic and medical history including prior cataract surgery. The association between prior cataract surgery and cognitive function was determined.
A total of the 2764 subjects whose mean age was 76.3±4.8 years (±standard deviation) was studied. Of these, 668 individuals (24.2%) had undergone cataract surgery. Of these, 150 (5.4%) had dementia as determined by the Mini-Mental State Examination (MMSE) score ≤23, and 877 individuals (31.7%) had mild cognitive impairment (MCI; MMSE score 24-26). The subjects who had prior cataract surgery had significantly lower odds ratio (OR) of having MCI (OR = 0.78, 95% confidence interval; CI 0.64-0.96, P = 0.019) than those who had not had cataract surgery after adjusting for age, sex, body mass index, education, hypertension, diabetes, depression, and history of stroke. The OR was still lower when the visual acuity was also added to the adjusted factors (OR 0.79, 95% CI 0.64-0.97, P = 0.025). However, prior cataract surgery did not contribute significantly to the low OR for dementia.
Cataract surgery may play a role in reducing the risk of developing MCI independently of visual acuity but not for dementia.
确定在日本老年人群体中,既往白内障手术与认知功能之间是否存在显著关联。
日本奈良县奈良医科大学。
藤原京眼科研究是一项横断面流行病学研究。
研究对象为居住在奈良县且对招募通知做出回应的68岁及以上人群。所有研究对象均接受了全面的眼科检查,并回答了关于其社会人口统计学和病史(包括既往白内障手术)的问卷。确定既往白内障手术与认知功能之间的关联。
共研究了2764名平均年龄为76.3±4.8岁(±标准差)的受试者。其中,668人(24.2%)接受过白内障手术。在这些人中,根据简易精神状态检查表(MMSE)评分≤23确定有150人(5.4%)患有痴呆症,877人(31.7%)患有轻度认知障碍(MCI;MMSE评分24 - 26)。在对年龄、性别、体重指数、教育程度、高血压、糖尿病、抑郁症和中风病史进行调整后,既往接受过白内障手术的受试者发生MCI的优势比(OR)显著低于未接受白内障手术的受试者(OR = 0.78,95%置信区间;CI 0.64 - 0.96,P = 0.019)。当将视力也纳入调整因素时,OR仍然较低(OR 0.79,95% CI 0.64 - 0.97,P = 0.025)。然而,既往白内障手术对痴呆症的低OR值没有显著影响。
白内障手术可能在独立于视力的情况下降低发生MCI的风险,但对痴呆症无此作用。