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Higher dementia incidence in older adults with poor visual acuity

Lee, ATC; Richards, M; Chan, WC; Chiu, HFK; Lee, RSY; Lam, LCW; (2020) Higher dementia incidence in older adults with poor visual acuity. The Journals of Gerontology: Series A 10.1093/gerona/glaa036. (In press). Green open access

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Abstract

BACKGROUND: Longitudinal evidence of poor visual acuity associating with higher risk of incident dementia is mixed. This study aimed to examine if poor visual acuity was associated with higher dementia incidence in a large community cohort of older adults, independent of the possible biases relating to misclassification error, reverse causality, and confounding effects due to health problems and behaviours. METHODS: A total of 15,576 community-living older adults without dementia at baseline were followed for 6 years to the outcome of incident dementia, which was diagnosed according to the ICD-10 or a Clinical Dementia Rating of 1 to 3. Visual acuity was assessed using the Snellen's chart at baseline and follow-up. Important variables including demographics (age, sex, education, and socioeconomic status), physical and psychiatric comorbidities (cardiovascular risks, ophthalmological conditions, hearing impairment, poor mobility, and depression), and lifestyle behaviours (smoking, diet, physical, intellectual, and social activities) were also assessed. RESULTS: Over 68,904 person-years of follow-up, 1,349 participants developed dementia. Poorer visual acuity at baseline was associated with higher dementia incidence in 6 years, even after adjusting for demographics, health problems, and lifestyle behaviours, and excluding those who developed dementia within 3 years after baseline. Compared with normal vision, the hazard ratio of dementia was 1.19 (p=0.31), 2.09 (p<0.001), and 8.66 (p<0.001) for mild, moderate, and severe visual impairment, respectively. CONCLUSIONS: Moderate-to-severe visual impairment could be a potential predictor and possibly a risk factor for dementia. From a clinical perspective, older adults with poor visual acuity might warrant further risk assessment for dementia.

Type: Article
Title: Higher dementia incidence in older adults with poor visual acuity
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/gerona/glaa036
Publisher version: https://doi.org/10.1093/gerona/glaa036
Language: English
Additional information: © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: cognitive impairment, poor vision, visual impairment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10095632
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