Vision loss and 12-year risk of dementia in older adults: the 3C cohort study

Naël, Virginie; Pérès, Karine; Dartigues, Jean‐François; Letenneur, Luc; Amieva, Hélène; Arleo, Angelo; Scherlen, Anne-Catherine; Tzourio, Christophe; Berr, Claudine; Carrière, Isabelle; Delcourt, Cécile; Helmer, Catherine

doi:10.1007/s10654-018-00478-y

Cited by 65 publications

(72 citation statements)

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“…Based on a retrospective cohort study that included 7,685 patients, Davies-Kershaw et al (2018) revealed that patients who rated their own vision as moderate were two times (HR 2.0, CI 95% 1.4-3.1) and those with very poor vision, which was comparable to being blind, four times (HR 4.0, CI 95% 2.6-6.1) more likely to have dementia compared to those without vision impairment. Furthermore, based on a population cohort of 7,736 initially healthy and non-dementia patients, Naël et al (2019) revealed that moderate to severe near-vision impairment was also associated with an increased risk of dementia in the first 4 years of follow-up (HR 2.0, CI 95% 1.2-3.3), but not when patients were followed for more than 4 years. Furthermore, self-reported vision impairment was associated with an increased risk of dementia within the time frame of 4 years (HR 1.5, CI 95% 1.1-2.0), but this association was no longer significant after adjusting for important baseline covariates, such as cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

“…Based on a retrospective cohort study, Davies-Kershaw et al (2018) revealed that moderate and severe vision loss was significantly associated with an increased risk of dementia. However, despite this and other evidence (Reyes-Ortiz et al, 2005;Clemons et al, 2006;Pham et al, 2006;Rogers and Langa, 2010;Davies-Kershaw et al, 2018), longitudinal studies have shown inconclusive evidence concerning the association between vision loss and the risk of dementia (Lin et al, 2004;Reyes-Ortiz et al, 2005;Sloan et al, 2005;Valentijn et al, 2005;Fischer et al, 2016;Hong et al, 2016;Naël et al, 2019). Most studies have focused on the cognitive decline rather than on dementia, used varied diagnostic criteria, or have been based on a subjective rather than an objective assessment, using small sample sizes or cross-sectional data.…”

Section: Introductionmentioning

confidence: 99%

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Association Between Hearing and Vision Impairment and Risk of Dementia: Results of a Case-Control Study Based on Secondary Data

Michalowsky

Hoffmann

Kostev³

2019

Front. Aging Neurosci.

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Introduction: Hearing and vision loss are highly prevalent in elderly adults, and thus frequently occur in conjunction with cognitive impairments. Studies have shown that hearing impairment is associated with a higher risk of dementia. However, evidence concerning the association between vision loss and dementia, as well as the co-occurrence of vision and hearing loss and dementia, has been inconclusive. Objectives: To assess the association between: (i) either hearing or vision loss and the risk of dementia, as well as between; and (ii) the combination of both sensory impairments and the risk of dementia. Methods: This case-control study was based on a 5-year data set that included patients aged 65 years and older who had initially been diagnosed with dementia diseases by one of 1,203 general practitioners in Germany between January 2013 and December 2017. In total, 61,354 identified dementia cases were matched to non-dementia controls, resulting in a sample size of 122,708 individuals. Hearing loss and vision loss were identified using the ICD-10 diagnoses documented in the general practitioners' files prior to the initial dementia diagnosis. Multivariate logistic regression models were fitted to evaluate the associations between visual and/or hearing impairment and the risk of dementia and controlled for sociodemographic and clinical variables. Results: Hearing impairment was documented in 11.2% of patients with a dementia diagnosis and 9.5% of patients without such a diagnosis. Some form of vision impairment was documented in 28.4% of patients diagnosed with dementia and 28.8% of controls. Visual impairment was not significantly associated with dementia (OR = 0.97, CI = 95% 0.97-1.02, p = 0.219). However, patients with hearing impairment were at

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association Between Hearing and Vision Impairment and Risk of Dementia: Results of a Case-Control Study Based on Secondary Data

Michalowsky

Hoffmann

Kostev³

2019

Front. Aging Neurosci.

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“…Hearing loss and vision loss have been associated with dementia in HIC (38)(39)(40)(41)(42), but evidence for these associations in Latin America or other LMIC is lacking. The current results suggest that eye problems, but not hearing problems, are associated with an increased risk of dementia in Cuban older adults, but only in the older age group.…”

Section: Health Factorsmentioning

confidence: 99%

Risk Factors for Incident Dementia Among Older Cubans

Peeters

Sanchez

Guerra

et al. 2020

Front. Public Health

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Introduction: Little is known about risk factors of dementia in Latin American countries. We aimed to identify socio-demographic, health and lifestyle risk factors of incident dementia in Cuban older adults. Methods: Data were from 1,846 participants in the Cuban cohort of the 10/66 Dementia Research Group. Participants completed questionnaires, health examinations, and cognitive tests at baseline (2003-2006) and 4.5 years later (2007-2010). Associations between risk factors (baseline) and incident dementia (follow-up) were examined using logistic regression. Results: Just over 9% of participants developed dementia. Overall, older age and low physical activity were associated with incident dementia. In those 65-74 years of age, depression, stroke and low physical activity were associated with incident dementia. In those ≥75 years of age, low physical activity, never eating fish, and smoking were associated with incident dementia. Conclusions: Modifiable lifestyle factors play an important role in developing dementia in Cuban older adults. This knowledge opens up opportunities for preventive strategies.

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“…Recent reviews highlighted that sensory deterioration such as vision and hearing loss can both contribute to or be a consequence of cognitive decline through both direct and indirect mechanisms [ 6 ]. For example, dementia-related cortical vision processing abnormalities may give rise to such a link [ 4 , 7 ], but visual problems have also been found to precede cognitive decline and increase the risk of dementia [ 5 , 8 , 9 ]. However, the mechanisms suggested for this association are being debated, including functional disability affecting engagement with cognitively stimulating activities [ 5 , 8 , 10 ] and interaction with depressive symptomology [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…For example, dementia-related cortical vision processing abnormalities may give rise to such a link [ 4 , 7 ], but visual problems have also been found to precede cognitive decline and increase the risk of dementia [ 5 , 8 , 9 ]. However, the mechanisms suggested for this association are being debated, including functional disability affecting engagement with cognitively stimulating activities [ 5 , 8 , 10 ] and interaction with depressive symptomology [ 8 ]. Overall, it is suggested that addressing global sensory deterioration may significantly impact the quality of life for PWD and their caregivers [ 9 - 11 ], with some studies suggesting that routine sight-restoring treatments such as cataract surgery have the potential to modify the trajectory of cognitive decline [ 12 ] or increase gray matter volume [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Binocular Vision, Visual Function, and Pupil Dynamics in People Living With Dementia and Their Relation to the Rate of Cognitive Decline and Structural Changes Within the Brain: Protocol for an Observational Study

2020

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Background Visual impairment is a common comorbidity in people living with dementia. Addressing sources of visual difficulties can have a significant impact on the quality of life for people living with dementia and their caregivers. Depth perception problems are purportedly common in dementia and also contribute to falls, visuomotor task difficulties, and poorer psychosocial well-being. However, depth perception and binocular vision are rarely assessed in dementia research. Sleep fragmentation is also common for people living with dementia, and binocular cooperation for depth perception can be affected by fatigue. Pupillary responses under cognitive load also have the potential to be a risk marker for cognitive decline in people living with dementia and can be combined with the above measures for a comprehensive evaluation of clinical visual changes in people living with dementia and their relation to changes in cognitive status, sleep quality, and cortical structure or function. Objective This study aims to characterize the nature of clinical visual changes and altered task-evoked pupillary responses that may occur in people living with dementia and evaluate whether these responses relate to changes in cognitive status (standardized Mini Mental State Examination [MMSE] score), Pittsburgh sleep quality index, and cortical structure or function. Methods This proposed exploratory observational study will enroll ≤210 people with recently diagnosed dementia (within the last 24 months). The following parameters will be assessed on 3 occasions, 4 months apart (plus or minus 2 weeks): visual function (visual acuity and contrast sensitivity), binocular function (motor fusion and stereopsis), task-evoked pupillary responses (minimum and maximum pupil size, time to maximum dilation, and dilation velocity), cognitive status (MMSE score), and sleep quality (Pittsburgh Sleep Quality Index). A subset of patients (n=30) with Alzheimer disease will undergo structural and functional magnetic resonance imaging at first and third visits, completing a 10-day consensus sleep diary to monitor sleep quality, verified by sleep actimetry. Results This research was funded in February 2018 and received National Health Service Research Ethics Committee approval in September 2018. The data collection period was from October 1, 2018, to November 30, 2019. A total of 24 participants were recruited for the study. The data analysis is complete, with results expected to be published before the end of 2020. Conclusions Findings will demonstrate how often people with dementia experience binocular vision problems. If frequent, diagnosing and treating them could improve quality of life by reducing the risk of falls and fine visuomotor task impairment and by relieving psychosocial anxiety. This research will also demonstrate whether changes in depth perception, pupillary responses, and quality of vision relate to changes in memory or sleep quality and brain structure or function. If related, these quick and noninvasive eye tests help monitor dementia. This would help justify whether binocular vision and pupillary response testing should be included in dementia-friendly eye-testing guidelines. International Registered Report Identifier (IRRID) RR1-10.2196/16089

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Vision loss and 12-year risk of dementia in older adults: the 3C cohort study

Abstract: Bordeaux 2 Victor Segalen and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The Three-City study is also supported by the

Cited by 65 publications

References 48 publications

Association Between Hearing and Vision Impairment and Risk of Dementia: Results of a Case-Control Study Based on Secondary Data

Association Between Hearing and Vision Impairment and Risk of Dementia: Results of a Case-Control Study Based on Secondary Data

Risk Factors for Incident Dementia Among Older Cubans

Binocular Vision, Visual Function, and Pupil Dynamics in People Living With Dementia and Their Relation to the Rate of Cognitive Decline and Structural Changes Within the Brain: Protocol for an Observational Study

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