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Invited Commentary
September 2017

Complex Relationships Between Vision and Cognition in Older People

Author Affiliations
  • 1Clinical Research Department, London School of Hygiene and Tropical Medicine, London, England
JAMA Ophthalmol. 2017;135(9):971-972. doi:10.1001/jamaophthalmol.2017.2843

Visual impairment and dementia are both conditions of aging. For this reason, the prevalence of both these age-related conditions is increasing as our populations become older. In this issue of JAMA Ophthalmology, Chen et al1 report the association between visual impairment and cognitive function in 2 large, nationally representative, cross-sectional studies of older people in the United States: the National Health and Nutrition Examination Survey, from 1999 to 2002, and the National Health and Aging Trends Study of Medicare beneficiaries, from 2011 to 2015. In the National Health and Nutrition Examination Survey, cognitive function was measured using the Digit Symbol Substitution Test, whereas in the National Health and Aging Trends Study, a diagnosis of probable or possible dementia was made using a combination of self-report and an 8-item questionnaire. In both of these studies, people with visual impairment (measured or self-reported) had 2- to 3-fold increased odds of cognitive impairment or dementia. Is this a real finding, and if so, what does it mean?

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