Premium
The longitudinal association of vision impairment with transitions to cognitive impairment and dementia
Author(s) -
Ehrlich Joshua R,
Swenor Bonnielin K,
Zhou Yunshu,
Langa Kenneth M
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.050340
Subject(s) - dementia , logistic regression , odds , odds ratio , cognition , longitudinal study , psychological intervention , psychology , population , medicine , gerontology , cognitive decline , demography , psychiatry , disease , environmental health , pathology , sociology
Background Vision impairment (VI) has been identified as a potentially modifiable risk factor for dementia. However, it is not known at what stage of cognitive decline VI exerts an effect. The purpose of this study was to determine whether VI increases the risk of transitions from normal to cognitive impairment no dementia (CIND) and/or from CIND to dementia. These findings may inform understanding of mechanistic processes, as well as the development and implementation of future dementia prevention interventions. Method We used longitudinal data including visual acuity and cognitive status from the population‐based Aging, Demographics and Memory Study (ADAMS), a sample drawn from the U.S. Health and Retirement Study. The covariate‐adjusted associations between VI (binocular distance visual acuity <20/40) and odds of cognitive transitions (normal to CIND, CIND to dementia) were evaluated using a series of multivariable logistic regression models. Result A total of 351 ADAMS participants without dementia at baseline were included (49.6% female, mean age 79.3 years, 21.7% with VI). Of these, 92 participants transitioned from normal to CIND and 76 transitioned from CIND to dementia during the course of the study. The odds of a transition from normal to CIND were 2.7 (95% CI 1.0‐7.5) times greater among those with VI, whereas the odds of a transition from CIND to dementia were not significantly associated with VI (OR= 0.8, 95% 0.4‐1.8). Conclusion This study indicates that poor vision is associated with transitions from normal to CIND but not from CIND to dementia, suggesting that the impact of VI is greatest early in the process of cognitive decline.