Association Between Visual Impairment and Decline in Cognitive Function in a Multiethnic Asian Population

Abstract

IMPORTANCE With the rapidly aging population, the burden of visual impairment (VI) and cognitive decline is expected to increase. Previous cross-sectional studies suggest an association between these 2 health outcomes. However, few longitudinal reports have examined this association, and to our knowledge, no studies have been performed in Asian populations. Further investigation on this association may help to better identify individuals at risk of cognitive decline. OBJECTIVE To examine the longitudinal association between VI and decline in cognitive function in a multiethnic Asian population. DESIGN, SETTING, AND PARTICIPANTSIn this longitudinal, population-based, prospective cohort study, Chinese, Indian, and Malay adults 60 years or older at baseline were recruited from the Singapore Epidemiology of Eye Diseases (SEED) study. At baseline, participants from the SEED study were recruited under 3 studies: the Singapore Malay Eye Study (SiMES;, the Singapore

The Association of Late-Life Self-Reported Vision and Hearing Impairments with Cognitive Function: A 3-Year Longitudinal Mediation Analysis Through Social Isolation

“…As noted, social isolation has been proposed as a potential mediator of the association between decreased sensory and cognitive functions (Livingston et al, 2020; Lim et al, 2020; Wahl & Heyl, 2003; Whitson et al, 2018). Vision and hearing are basic forms of interchange between individuals and their environment.…”

“…Sensory impairments may also increase the cognitive load required for sensory processing, which may lead to poor cognitive outcomes (Pigeon et al, 2019) or result in direct alteration of brain structure, including both regional and whole-brain atrophy, due to decreased afferent sensory input (Hultsch et al, 1999; Lin et al, 2014; McEwen, 2000; Peelle et al, 2011,Whitson, 2018). Conversely, preserving sensory function may be protective of cognitive function and brain structure in both vision (Lim et al, 2020; Tamura et al, 2004; Xu et al, 2014) and hearing (Dawes et al, 2015).…”

“…Vision and hearing are basic forms of interchange between individuals and their environment. When typical forms of communication are interrupted, as in the case of VI and HI, there is evidence that both social isolation (National Academies of Sciences, Engineering, and Medicine et al, 2020; Shah et al, 2020; Shukle et al, 2020) and subsequent cognitive impairment may ensue (Lim et al, 2020). Individuals with self-reported vision impairments are less likely to engage in out-of-home leisure activities (Heyl et al, 2005) or to socialize with friends or participate in social activities (Crews & Campbell, 2001).…”

“…Individuals with self-reported vision impairments are less likely to engage in out-of-home leisure activities (Heyl et al, 2005) or to socialize with friends or participate in social activities (Crews & Campbell, 2001). However, socially engaging activities provide cognitive stimulation, which may protect against cognitive decline (Lim et al, 2020; Lövdén et al, 2005; Whitson et al, 2018). This is consistent with the cascade hypothesis, in which cognitive decline is driven by a lack of cognitive stimulation related to sensory loss (Varadaraj, et al, 2020; Wahl & Heyl, 2003).…”

The Association of Cognitive and Visual Function in a Nationally Representative Study of Older Adults in India

“…Vision impairment (VI), which affects over 1 billion people globally [7], may be one such modifiable risk factor since up to 80% of VI and blindness is avoidable or treatable, often with low-cost interventions like cataract surgery and eyeglasses [8]. In various settings and populations, prior studies have demonstrated that VI is associated with cognitive decline and dementia [9][10][11][12][13][14]. However, several important gaps remain in understanding the nature of this association.…”