Abstract
Purpose :
Our goal was to explore the longitudinal associations between vision-related variables and cognitive test change scores in a community-dwelling sample of older adults and to examine whether sex, education, or hearing loss act as effect modifiers.
Methods :
A 3-year prospective cohort study was performed using data from the Canadian Longitudinal Study on Aging consisting of 30,097 individuals aged 45-85 years. Visual impairment (VI) was defined as binocular presenting visual acuity worse than 20/40. Participants were asked if they had ever had a physician diagnosis of age-related macular degeneration (AMD), glaucoma, or cataract. Cognitive change was examined by calculating the difference between baseline and follow-up scores of the Rey Auditory Verbal Learning Test (RAVLT: a test of verbal memory), the Controlled Oral Word Association Test (COWAT: a test of verbal letter fluency), the Animal Naming Test (ANT: a test of verbal category fluency) and the Mental Alternation Test (MAT: a test of processing speed). Multiple linear regression was used and sampling weights were included in all models.
Results :
Visual impairment was associated with the 3-year decrease in RAVLT (β=-0.18, 95% confidence interval (CI)= -0.28, -0.07), RAVLT-Delayed (β=-0.13, 95% CI= -0.25, -0.02), and ANT (β=-0.95, 95% CI= -1.44, -0.45) scores after adjusting for age, sex, ethnicity, income, smoking, diabetes, stroke, heart disease, baseline cognitive score, and province. A report of glaucoma was associated with a decrease in 3-year MAT change scores (β=-0.40, 95% CI -0.77, -0.04). The self-report of AMD or cataract were not associated with 3-year changes in cognitive test scores. No effect modification was detected.
Conclusions :
These data indicate that VI and glaucoma are associated with 3-year declines in cognitive test scores. Further research is needed to elucidate the pathways to explain these associations.
This is a 2021 ARVO Annual Meeting abstract.