Visual impairment in aging and cognitive decline: experience in a Memory Clinic

• Published in: Scientific reports Vol. 9; no. 1; pp. 8698 - 10
• Main Authors: Marquié, Marta, Castilla-Martí, Miguel, Valero, Sergi, Martínez, Joan, Sánchez, Domingo, Hernández, Isabel, Rosende-Roca, Maitée, Vargas, Liliana, Mauleón, Ana, Rodríguez-Gómez, Octavio, Abdelnour, Carla, Gil, Silvia, Santos-Santos, Miguel A., Alegret, Montserrat, Espinosa, Ana, Ortega, Gemma, Pérez-Cordón, Alba, Sanabria, Ángela, Roberto, Natalia, Moreno-Grau, Sonia, de Rojas, Itziar, Simó, Rafael, Ciudin, Andreea, Hernández, Cristina, Orellana, Adelina, Monté-Rubio, Gemma, Benaque, Alba, Ruiz, Agustín, Tárraga, Lluís, Boada, Mercè
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 18.06.2019; Nature Publishing Group; Nature Portfolio
• Subjects: 692/617/375/132/1283; 692/699/3161; Acuity; Aged; Aged, 80 and over; Aging; Alzheimer's disease; Cognitive ability; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - physiopathology; Cohort Studies; Dementia; Dementia - diagnosis; Dementia - physiopathology; Dementia disorders; Female; Frontotemporal dementia; Geriatrics; Humanities and Social Sciences; Humans; Intraocular Pressure - physiology; Lewy bodies; Logistic Models; Male; Memory; Memory - physiology; Middle Aged; multidisciplinary; Neurodegenerative diseases; Neurological complications; Neuropsychological Tests - statistics & numerical data; Older people; Outpatient Clinics, Hospital; Quality of Life; Science; Science (multidisciplinary); Tomography, Optical Coherence - methods; Vascular dementia; Vision Disorders - diagnosis; Vision Disorders - physiopathology; Visual Acuity - physiology; Visual impairment; Visual perception
• ISSN: 2045-2322; 2045-2322
• 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.