Visual Impairment, Age-Related Eye Diseases, and Cognitive Function: The Singapore Malay Eye Study | Geriatrics | JAMA Ophthalmology | JAMA Network
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July 2012

Visual Impairment, Age-Related Eye Diseases, and Cognitive Function: The Singapore Malay Eye Study

Author Affiliations

Author Affiliations: Singapore Eye Research Institute, Singapore National Eye Centre (Ms Ong, Drs Cheung, Lamoureux, Ikram, Ding, Cheng, Saw, and Wong, and Mr Li), Duke-NUS Graduate Medical School (Ms Ong and Drs Cheung, Lamoureux, Ikram, Cheng, Haaland, and Wong), and Departments of Epidemiology and Public Health (Drs Ikram, Cheng, and Saw), Statistics and Applied Probability (Dr Haaland), and Pharmacology (Dr Chen), Division of Neurology, National University Hospital (Drs Ikram and Venketasubramanian), and Department of Ophthalmology, Yong Loo Lin School of Medicine (Drs Cheung, Cheng, and Wong), National University of Singapore, Singapore; Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia (Drs Lamoureux and Wong); and Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands (Dr Ikram).

Arch Ophthalmol. 2012;130(7):895-900. doi:10.1001/archophthalmol.2012.152

Objective To describe the associations of visual impairment and major age-related eye diseases with cognitive function in an older Asian population.

Methods A population-based, cross-sectional study of 1179 participants aged 60 to 80 years from the Singapore Malay Eye study was conducted. Visual acuity was measured using the logMAR vision chart. Cataract and age-related macular degeneration were graded using the Wisconsin Cataract Grading System and the Wisconsin Age-Related Maculopathy Grading System, respectively. Glaucoma was diagnosed using the International Society Geographical and Epidemiological Ophthalmology criteria. Diabetic retinopathy was graded using the modified Airlie House classification system. Cognitive dysfunction was defined as a locally validated Abbreviated Mental Test using education-based cutoff scores.

Results After adjusting for age, sex, education level, income, and type of housing, persons with visual impairment before refractive correction (odds ratio [OR] = 2.59; 95% CI, 1.89-3.56) or after refractive correction (OR = 1.96; 95% CI, 1.27-3.02) and those with visual impairment due to cataract (OR = 2.75; 95% CI, 1.35-5.63) were more likely to have cognitive dysfunction. Only moderate to severe diabetic retinopathy was independently associated with cognitive dysfunction (OR = 5.57; 95% CI, 1.56-19.91) after controlling for concurrent age-related eye diseases. No significant independent associations were observed between cataract, age-related macular degeneration, or glaucoma and cognitive dysfunction.

Conclusions Older persons with visual impairment, particularly those with visual impairment due to cataract, were more likely to have cognitive dysfunction. Furthermore, among the major age-related eye diseases, only diabetic retinopathy was associated with cognitive dysfunction.