Midlife Vision Impairment and Cognitive Function in Later Life: The Study of Women’s Health Across the Nation, Michigan Cohort

Abstract

Background In older adults, vision impairment (VI) is associated with worse cognitive function. However, the relationship between mid-life vision and future cognitive function remains unknown. Methods The Study of Women’s Health Across the Nation (SWAN), Michigan site, is a longitudinal cohort of mid-life women age 42-52 years at baseline. Presenting Titmus visual acuity (VA) in the better-seeing eye was assessed at baseline and categorized as no or mild VI (VA ≥20/60), or moderate or worse VI (VA <20/60). Cognitive function was measured 8 times over 15 years using the East Boston Memory Test immediate (EBMTi) and delayed (EBMTd) recall and the Digit Span Backwards (DSB) test. Linear mixed models with a random intercept and slope for age were constructed to detect associations between VI at baseline and future repeated measures of cognitive function, adjusting for age, race, education, financial strain, alcohol use, and tobacco use. Results 394 women age 42-52 at baseline with maximum follow-up of 20 years were included in this analysis. After covariate adjustment, moderate or worse VI was associated with lower EMBTi (β= -0.56, p=0.012), EBMTd (β= -0.60, p=0.009) and DSB (β= -0.84, p=0.04). While we detected significant associations between VI and levels of cognitive function scores, rates of cognitive decline as individuals aged did not vary by VI status. Conclusion Moderate or worse VI, assessed during mid-life, was associated with lower scores on measures of cognitive function over a 15 year period during which women transitioned from mid-life to older adulthood.

Human restricted CHRFAM7A gene increases brain efficiency

“…BVMT-R is associated with right hemisphere visual networks in MS ( Fuchs et al, 2019 ). Visual spatial function in middle age has emerged as the main predictor of cognitive decline later in life, and this correlation has been hypothesized as the first measurable decline ( Possin, 2010 ; Salimi et al, 2018 ; Kolli et al, 2021 ; Berente et al, 2022 ). Informed by the underlying cell biology of CHRFAM7A, the association between visual spatial function and cognitive decline could be driven by a more resilient neuronal structure measured by the visual spatial relative strength, latently detecting CHRFAM7A direct allele carriers.…”

How does visual perception change for people with cognitive decline? A Scoping Review

“…The common cause hypothesis proposes that declines in both cognitive and sensory domains occur due to more general age-related neurological changes. Several common pathological causes underpinning sensory impairment and dementia have been suggested; for example, vasculopathy, neurodegeneration, macular degeneration, and distinct genetic risk factors [5,15,18,19]; shared risk factors, such as diabetes and hypertension have also been proposed [4]. The sensory deprivation hypothesis suggests that decreased visual input leads to reduced participation in cognitively stimulating activities and social isolation.…”

“…Two of the studies used data from longitudinal women's health cohort studies [15,27]. 'Moderate' and 'worse' visual acuity scores were signi cantly associated with poorer performance on various measures of cognition including the East Boston Memory Test (immediate and delayed) and the Digit Span Backwards Test in a midlife-older female sample [15]. However, the severity of visual impairment and the rate of cognitive decline was not signi cantly related to the severity of visual impairment.…”