Health Services & Systems Research, Duke-NUS Medical School, Singapore.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Age Ageing. 2022 May 1;51(5). doi: 10.1093/ageing/afac107.
The relationship between baseline cognitive impairment (CI) and incident visual impairment (VI) in Asians is unclear.
To determine the associations between baseline CI with incident VI and visual acuity (VA) at 6-year follow-up in multiethnic Asians.
Cohort.
Population-based.
Two thousand three hundred and twenty-four adults aged ≥60 years from the Singapore Epidemiology of Eye Diseases Study (response rate 64%).
CI was defined using the validated Abbreviated Mental Test (AMT). VA was objectively measured using a LogMAR chart. Any incident VI was defined as having no VI (Snellen's VA better than or equal to 20/40) at baseline but present (VA worse than 20/40) at 6-year follow-up. VI severity was defined according to the International Classification of Diseases, 11th Revision. Associations were assessed using logistic and linear regression models.
Of the 2,324 participants, 248 had CI at baseline. Presence of baseline CI was associated with more than twice the odds of any incident VI, incident mild and moderate-severe VI (OR [95% confidence interval]: 2.48 [1.55-3.90], 2.07 [1.17-3.55], and 2.61 [1.36-4.93], respectively) and worse VA (β [95% confidence interval]: 0.026 [0.006-0.046]) at 6-year follow-up. The leading causes of incident VI were cataract and under-corrected refractive error.
Older adults with CI had more than double the odds of VI development and poorer VA than their cognitively intact counterparts, and most causes of incident VI were correctable. Strategies such as targeted vision screening and early intervention for early detection and management of vision loss in patients with cognitive decline are warranted.
亚洲人群中，基线认知障碍（CI）与新发视力障碍（VI）之间的关系尚不清楚。
确定多民族亚洲人群中基线 CI 与 VI 发病及 6 年随访时视力（VA）之间的相关性。
队列研究。
基于人群。
来自新加坡眼病流行病学研究（应答率为 64%）的 2324 名年龄≥60 岁的成年人。
采用经过验证的简易智力测试（AMT）定义 CI。使用 LogMAR 图表客观测量 VA。任何新发 VI 定义为基线时无 VI（Snellen 视力优于或等于 20/40）但在 6 年随访时存在（视力差于 20/40）。根据国际疾病分类第 11 版（ICD-11）定义 VI 严重程度。使用逻辑回归和线性回归模型评估相关性。
在 2324 名参与者中，有 248 名基线时存在 CI。基线时存在 CI 与新发任何 VI、新发轻度和中度重度 VI 的几率增加两倍以上相关（OR[95%置信区间]：2.48[1.55-3.90]、2.07[1.17-3.55]和 2.61[1.36-4.93]），且 6 年随访时 VA 更差（β[95%置信区间]：0.026[0.006-0.046]）。新发 VI 的主要原因是白内障和未矫正的屈光不正。
认知障碍的老年患者发生 VI 的几率增加两倍以上，VA 较认知正常者更差，大多数新发 VI 的原因是可矫正的。需要采取有针对性的视力筛查和早期干预策略，以早期发现和管理认知能力下降患者的视力丧失。
