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A.T. Broman, B. Munoz, K.A. Turano, G.S. Rubin, K. Bandeen-Roche, S.K. West; The Impact of Non-Visual Domains of Cognition on Visual Acuity Testing: The SEE Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):789.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the impact of various domains of cognition on measuring visual acuity and decline in acuity. Methods: A population-based sample of 1505 persons between the ages of 72-92 was enrolled in the third round of the Salisbury Eye Evaluation (SEE). Visual acuity was measured binocularly, using ETDRS charts, and the participant’s habitual distance correction. Three non-visually intensive tests of cognition were performed: the Brief Test of Attention (attention), Boston Naming Test (verbal fluency), and the Hopkins Verbal Learning Test (learning and memory). A measure of depression was taken from the General Health Questionnaire, and diabetes was determined from a medical history questionnaire. All analyses were adjusted for age, gender, race, and depression; diabetes, which could affect both vision and mental status, was also included in the models. Cross-sectional analyses were performed using multivariate linear models; longitudinal analyses were performed using logistic models predicting decline in acuity of one line or more. Results: Currently, 1025 participants have been enrolled in the fourth round of SEE, two years following Round 3. Cross-sectionally, higher scores in tests of attention (ß=–0.01, p<0.0001), verbal fluency (ß=–0.002, p=0.0004), and learning and memory (ß=–0.004, p=0.0008) were associated with better visual acuity. In a multivariate model including all three cognition measures, only better attention was significantly associated (ß=–0.006, p=0.03) with better acuity. Over the 2-year period, participants showed minimal change in cognition. Of the three cognition measures, only decline in verbal fluency had borderline association with decline in acuity (OR=0.0547, p=0.06); the other tests did not predict decline in vision. Conclusions: Cross-sectionally, higher attention is associated with better scores in visual acuity. We hypothesize that the ability to concentrate affects performance in reading the ETDRS chart. While cognition did not appear to be associated with change in acuity, this may be because of the relatively short time period between rounds 3 and 4.
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