Alzheimer Research Center and Memory Clinic, Fundació ACE Institut Català de Neurociències Aplicades - Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
Clínica Oftalmológica Dr. Castilla, Barcelona, Spain.
Sci Rep. 2019 Jun 18;9(1):8698. doi: 10.1038/s41598-019-45055-9.
Visual impairment is common in people living with dementia and regular ophthalmological exams may improve their quality of life. We evaluated visual function in a cohort of elderly individuals and analyzed its association with their degree of cognitive impairment. Participants underwent neurological and neuropsychological exams, neuro-ophthalmological assessment (visual acuity, intraocular pressure, rates of past ophthalmological pathologies, use of ocular correction, treatments and surgeries) and optical coherence tomography (OCT) scan. We analyzed differences in ophthalmological characteristics among diagnostic groups. The final sample of 1746 study participants aged ≥ 50 comprised 229 individuals with Subjective Cognitive Decline (SCD), 695 with mild cognitive impairment (MCI) and 833 with Dementia (Alzheimer disease: n = 660; vascular dementia: n = 92, Lewy body dementia: n = 34; frontotemporal dementia: n = 19 and other: n = 28). Age, gender and education were used as covariates. Patients with Dementia, compared to those with SCD and MCI, presented worse visual acuity (p < 0.001), used less visual correction (p = 0.02 and p < 0.001, respectively) and fewer ophthalmological treatments (p = 0.004 and p < 0.001, respectively) and underwent fewer ocular surgeries (p = 0.009 and p < 0.001, respectively). OCT image quality worsened in parallel to cognitive decline (Dementia vs SCD: p = 0.008; Dementia vs MCI: p < 0.001). No group differences in past ophthalmological disorders or abnormal OCT findings were detected. Efforts should be made to ensure dementia patients undergo regular ophthalmological assessments to correct their visual function in order to improve their quality of life.
视力障碍在痴呆症患者中很常见，定期进行眼科检查可能会提高他们的生活质量。我们评估了一组老年患者的视觉功能，并分析了其与认知障碍程度的关系。参与者接受了神经学和神经心理学检查、神经眼科评估（视力、眼压、过去眼科疾病的发生率、眼部矫正的使用、治疗和手术）和光学相干断层扫描（OCT）扫描。我们分析了不同诊断组之间眼科特征的差异。最终的样本包括 1746 名年龄在 50 岁及以上的参与者，其中 229 名患有主观认知下降（SCD），695 名患有轻度认知障碍（MCI），833 名患有痴呆症（阿尔茨海默病：n=660；血管性痴呆：n=92，路易体痴呆：n=34；额颞叶痴呆：n=19 和其他：n=28）。年龄、性别和教育程度被用作协变量。与 SCD 和 MCI 患者相比，痴呆症患者的视力更差（p<0.001），使用的视觉矫正更少（p=0.02 和 p<0.001），接受的眼科治疗更少（p=0.004 和 p<0.001），接受的眼部手术更少（p=0.009 和 p<0.001）。OCT 图像质量随着认知能力下降而恶化（痴呆症与 SCD：p=0.008；痴呆症与 MCI：p<0.001）。未发现各组在过去的眼科疾病或异常的 OCT 发现方面存在差异。应努力确保痴呆症患者定期进行眼科评估，以矫正他们的视力功能，从而提高他们的生活质量。
