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Dandan Diane Zheng, Sharon L Christ, Bonnielin K Swenor, Sheila West, Byron L Lam, David J Lee; Longitudinal Relationship between Visual Acuity and Cognitive functioning in Community Residing Older Adults: The Salisbury Eye Evaluation Study.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1341. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe visual acuity (VA) and Mini-Mental State Examination (MMSE) trajectories among aging adults and to estimate the relationships between these trajectories.
A population-based sample of 2,520 white and black individuals aged 65–84 years were assessed at baseline in 1993-1995 and at two, six, and eight years later. Presenting VA was measured using ETDRS charts and the cognitive status was assessed using the MMSE. Eligible participants had to have a MMSE score of greater than 17. Latent Growth Curve modeling was used to estimate VA and MMSE trajectories and age-adjusted associations between these trajectories. A cross-lagged model was used to estimate how MMSE and VA affect each other during the follow-up period.
Both presenting VA and MMSE score worsened over time (VA (Log MAR) intercept=.004, slope=.022 for VA; MMSE intercept=27.3, slope=-.59; all P<.001). The intercept of VA trajectory is statistically significantly associated with the intercept of MMSE trajectory (r=-.267, se=.029, p <.001), suggesting that worse baseline VA is associated with worse baseline MMSE score. The baseline VA is also significantly associated with the subsequent rate of change in MMSE score (r=-.11, se=.05, p<.001). In addition, more positively sloped VA trajectories are significantly associated with more negatively sloped trajectories of MMSE(r=-.148, se=.061, p=.015); i.e., the rate of worsening VA is associated with the rate of declining MMSE score in older adults. Cross lagged models indicate worse VA in the previous round predicted worse MMSE score in the subsequent round throughout the study (β=-1.1, se=.2, p<0.001); however the reverse was not observed except declining MMSE score in round 1 predicted worse VA in round 2 (β=-.052, se=.013, p<0.001).
VA is associated with MMSE score cross-sectionally and, more importantly, longitudinally in older adults. The rate of VA decline is associated with the rate of MMSE score decline, indicating that worsening VA in older adults may adversely impact future cognitive functioning. This longitudinal relationship suggests that maintaining good vision may be an important interventional strategy for mitigating age-related cognitive changes.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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