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Shin Y. Ong, Carol YL Cheung, Ecosse Lamoureux, Seang-Mei Saw, N. Venketasubramanian, Christopher PL Chen, Tien Y Wong; Age-related Eye Diseases and Cognitive Impairment: The Singapore Malay Eye Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4233.
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To describe the associations between cognitive impairment, age-related eye disease, and visual impairment in an older Asian population.
Older participants aged 60 years and above were selected from the Singapore Malay Eye Study (SiMES), a population-based survey of Singapore Malays (n=1,484 out of 3,280). Cataract was assessed from lens photographs using the Wisconsin cataract grading system. Glaucoma was assessed according to International Society for Geographical and Epidemiologic Ophthalmology criteria. Retinopathy signs and age-related macular degeneration (AMD) were graded from fundus photographs using the modified Airline House classification system and the modified Wisconsin AMD grading system respectively. Best-corrected visual acuity was recorded with the logarithmic minimal angle resolution (logMAR), and visual impairment was defined as logMAR worse than 0.3. The locally validated Abbreviated Mental Test (AMT) was used to assess cognitive function, with use of education-specific cutoff scores.
The age-standardized prevalence of cognitive impairment was 21.0% (95% confidence interval [CI] 19.8 - 23.4) (n=345) in this older Malay population. After multivariate adjustment for age, gender, diabetes, hypertension, and LDL-cholesterol, persons with visual impairment had lower AMT scores (6.87 [SD 0.12] vs. 8.34 [SD 0.06], p<0.001) and were more likely to have cognitive impairment (odds ratio [OR] 2.61; 95% CI 1.95-3.49; p<0.001). Of the age-related eye diseases examined, only moderate to severe diabetic retinopathy was associated with cognitive impairment (OR 2.37; 95% CI 1.01-5.53; p= 0.047); no significant associations were observed between cataract (OR 1.17; 95% CI 0.87 - 1.57), glaucoma (OR 0.91; 95% CI 0.37 - 2.27), and AMD (OR 1.44; 95% CI 0.70 - 2.98) with cognitive impairment.
Older persons with visual impairment were more likely to have cognitive impairment. An association between moderate to severe diabetic retinopathy and cognitive impairment was also observed.
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