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Moon Jeong Lee, Varshini Varadaraj, Pradeep Y Ramulu, Heather Whitson, Jennifer A Deal, Bonnielin K Swenor; Subjective Memory Complaints in the Visually Impaired: An NHANES Analysis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5162.
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Prior studies have demonstrated that subjective memory complaints (SMC) are associated with an increased risk of developing dementia. As most neurocognitive tests are highly vision dependent, SMC may be a less biased method to identify adults with visual impairments (VI) who are at a risk of cognitive decline. Here, we examined the prevalence of SMC in older adults with VI using National Health and Nutrition Examination Survey (NHANES) data.
We analyzed data from the 1999-2006 cycles of the NHANES. We assessed the association between corrected visual acuity worse than 20/40 in the better-seeing eye and self-reported limitation due to confusion or problems with memory among participants aged 60-90 years (n=5795). Current Population Surveys were used to estimate prevalence of SMC. Chi squared and t-tests were used to compare demographic characteristics by group (VI vs. non-VI) and complex survey logistic regression was used to test associations. Co-variates were incorporated given their established importance to cognition and SMC.
The VI group was older than the non-VI group (77.8 ± 0.5 vs. 70.3 ± 0.2) and more likely to be female (61% VI vs. 55% non-VI) and Caucasian (79% VI vs. 83% non-VI). Among those aged ≥60 years, SMC were reported in 22% of the VI group and 11% of the non-VI group (p<0.001). When stratified by age, in individuals aged 60-79 years, similar rates of SMC were reported in the VI and non-VI group (p>0.05). However, among those ≥80 years old, 30% with VI as compared to 19% with no VI reported SMC (p=0.003). After adjusting for age, sex, race, marital status, depression and education, individuals with VI were more likely (RR: 1.33, p=0.004) to report SMC as compared to those without VI.
SMC are highly prevalent in older adults with VI, especially among the oldest old. Our results support the hypothesis that subjective memory assessments may be an important method for assessing functional difficulty due to memory problems in individuals with VI where vision-dependent tests of cognition may be less reliable. Further studies are needed to investigate the implications of SMC in individuals with VI and to determine the optimal way to assess cognition in adults with VI.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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