Age-related eye disease and cognitive status

Abstract

Purpose: To examine whether patients with age-related macular degeneration (AMD), glaucoma, or Fuchs corneal dystrophy have lower cognitive scores compared to a control group of older adults with good vision.

Methods: We recruited 345 patients (93 with bilateral AMD, 57 with bilateral Fuchs, 98 with bilateral glaucoma, and 97 controls) from the ophthalmology clinics of Maisonneuve-Rosemont Hospital (Montreal, Canada) to participate in a cross-sectional study from September, 2009 until July, 2012. Control patients who had normal visual acuity and visual field were recruited from the same clinics. Participants completed the Mini-Mental State Exam-blind version which excludes 8 items that rely on vision. People who scored ≤18 out of 22 were defined as having worse cognition. Logistic regression was used.

Results: 5% of the controls had worse cognition compared to 35% of AMD, 21% of Fuchs, and 29% of glaucoma patients (P<0.05). After adjusting for age, gender, education, race, and living alone, all 3 groups with eye disease still had worse cognition (P<0.05). Other variables associated with worse cognition included older age and lower levels of education.

Conclusions: Despite using a measurement instrument appropriate for people with impaired vision, patients with three age-related eye diseases had worse cognitive scores. Whether this is due to common biological mechanisms between eye disease and brain disease or whether this is due to decreased cognitive stimulation after loss of sight is unknown and should be further explored.

Keywords: 462 clinical (human) or epidemiologic studies: outcomes/complications • 412 age-related macular degeneration • 584 low vision