Almidani Louay, Varadaraj Varshini, Mihailovic Aleksandra, Ramulu Pradeep Y
From the Wilmer Eye Institute, Johns Hopkins University School of Medicine (L.A., A.M., P.Y.R.); Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing (V.V.), Baltimore, Maryland, USA.
From the Wilmer Eye Institute, Johns Hopkins University School of Medicine (L.A., A.M., P.Y.R.); Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing (V.V.), Baltimore, Maryland, USA..
Am J Ophthalmol. 2023 Nov;255:18-29. doi: 10.1016/j.ajo.2023.05.020. Epub 2023 Jun 5.
To evaluate the association between vision impairment (VI) and cognitive function using objective measures.
Cross-sectional analysis with a nationally representative sample.
The association between VI and dementia was investigated in a US population-based, nationally representative sample of Medicare beneficiaries, the National Health and Aging Trends Study (NHATS), a nationally representative sample of Medicare beneficiaries aged ≥65 years, using objective vision measures. Exposures included distance VI (>20/40), near VI (>20/40), contrast sensitivity impairment (CSI) (<1.55), any objective VI (distance and near visual acuity, or contrast), and self-reported VI. The main outcome measure was dementia status defined based on survey reports, interviews, and cognitive tests.
A total of 3026 adults were included in this study; the majority were female (55%) and White (82%). The weighted prevalence rates were 10% for distance VI, 22% for near VI, 22% for CSI, 34% for any objective VI, and 7% for self-reported VI. Across all measures of VI, dementia was more than twice as prevalent in adults with VI compared to their peers without (P < .001 for all). In adjusted models, all measures of VI were associated with higher odds of dementia (distance VI: OR 1.74, 95% CI 1.24-2.44; near VI: OR 1.68, 95% CI 1.29-2.18; CSI: OR 1.95, 95% CI 1.45-2.62; any objective VI: OR 1.83, 95% CI 1.43-2.35; self-reported VI: OR 1.86, 95% CI 1.20-2.89).
In a nationally representative sample of older US adults, VI was associated with increased odds of dementia. These results suggest that maintaining good vision and eye health may help preserve cognitive function in older age, although more research is needed to investigate the potential benefits of interventions that focus on vision and eye health on cognitive outcomes.
采用客观测量方法评估视力损害（VI）与认知功能之间的关联。
对具有全国代表性的样本进行横断面分析。
在美国基于人群的、具有全国代表性的医疗保险受益人群样本（国家健康与老龄化趋势研究，NHATS，年龄≥65岁的医疗保险受益人的全国代表性样本）中，使用客观视力测量方法研究VI与痴呆症之间的关联。暴露因素包括远距离视力损害（>20/40）、近距离视力损害（>20/40）、对比敏感度损害（CSI）（<1.55）、任何客观视力损害（远距离和近距离视力，或对比度）以及自我报告的视力损害。主要结局指标是根据调查报告、访谈和认知测试定义的痴呆症状态。
本研究共纳入3026名成年人；大多数为女性（55%）和白人（82%）。远距离视力损害的加权患病率为10%，近距离视力损害为22%，对比敏感度损害为22%，任何客观视力损害为34%，自我报告的视力损害为7%。在所有视力损害测量指标中，有视力损害的成年人患痴呆症的患病率是无视力损害同龄人（所有P < 0.001）的两倍多。在调整模型中，所有视力损害测量指标均与痴呆症的较高几率相关（远距离视力损害：比值比1.74，95%置信区间1.24 - 2.44；近距离视力损害：比值比1.68，95%置信区间1.29 - 2.18；对比敏感度损害：比值比1.95，95%置信区间1.45 - 2.62；任何客观视力损害：比值比1.83，95%置信区间1.43 - 2.35；自我报告的视力损害：比值比1.86，95%置信区间1.20 - 2.89）。
在具有全国代表性的美国老年成年人样本中，视力损害与痴呆症几率增加相关。这些结果表明，保持良好的视力和眼部健康可能有助于在老年时保持认知功能，尽管需要更多研究来调查关注视力和眼部健康的干预措施对认知结局的潜在益处。
