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E.Y. Chew, T.E. Clemons, M.L. Klein, B.E. K. Klein, R. Klein, T. Friberg, S. Bressler, Age–Related Eye Disease Study Research Group; Cognitive Function in the Age–Related Eye Disease Study (AREDS) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3056.
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Purpose: To investigate whether changes in visual acuity and progression to advanced age–related macular degeneration (AMD) are associated with change in cognitive function. Methods: AMD status and best–corrected visual acuity were measured in AREDS by trained examiners during study follow–up at the first and second administrations of the Cognitive Function (CF) battery. Cognitive function scores on 6 neuropsychological tests measured performance in several cognitive domains and on a depression scale. Analysis of the association between progression to advanced AMD and of change in visual acuity with change in CF scores was conducted using generalized linear models. Results: 1,798 AREDS participants completed two administrations of the CF Battery. The median time between administrations was 2 years. Of the 1,575 participants with at least one eye available for AMD progression and photographs available at both administrations, 139 progressed to advanced AMD. Progression to AMD was associated with decreased cognitive function score for the Modified Mini–Mental State Examination (3MS). Participants who progressed to AMD scored lower on the second administration compared with participants who did not progress (Mean difference –1.25 versus –0.39). Of the 1,564 participants who had vision of 20/200 or better at the first administration and visual acuity measurements at both administrations, 270 had at least a 2–line decrease in vision between administrations. A 2–line decrease in visual acuity in at least one eye was associated with a decrease in 3MS score compared to participants with visual acuity that did not similarly decrease in either eye (Mean difference –1.06 versus –0.29). The difference remained significant for AMD and visual acuity progression after covariate adjustment. Conclusion: These data suggest an association between change in ocular status and change in cognitive function test scores.
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