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Objectively Measured Visual Impairment and Dementia Prevalence in Older Adults in the US
Killeen OJ, Zhou Y, Ehrlich JR.. JAMA ophthalmology, 2023-08-01
Topic: Brain imaging, connectivity and assessment
Importance Estimates of the association between visual impairment (VI) and dementia in the US population are based on self-reported survey data or measures of visual function that are at least 15 years old. Older adults are at high risk of VI and dementia so there is a need for up-to-date national estimates based on objective assessments. Objective To estimate the association between VI and dementia in older US adults based on objective visual and cognitive function testing. Design, setting, and participants This secondary analysis of the 2021 National Health and Aging Trends Study (NHATS), a population-based, nationally representative panel study, included 3817 respondents 71 years and older. Data were analyzed from January to March 2023. Intervention In 2021, NHATS incorporated tablet-based tests of distance and near visual acuity and contrast sensitivity (CS) with habitual correction. Main outcomes and measures VI was defined as distance visual acuity more than 0.30 logMAR, near visual acuity more than 0.30 logMAR, and CS more than 1 SD below the sample mean. Dementia was defined as scoring 1.5 SDs or more below the mean in 1 or more cognitive domains, an AD8 Dementia Screening Interview Score indicating probable dementia, or diagnosed dementia. Poisson regression estimated dementia prevalence ratios adjusted for covariates. Results Of 2967 included participants, 1707 (weighted percentage, 55.3%) were female, and the median (IQR) age was 76.9 (77-86) years. The weighted prevalence of dementia was 12.3% (95% CI, 10.9-13.7) and increased with near VI (21.5%; 95% CI, 17.7-25.3), distance VI (mild: 19.1%; 95% CI, 13.0-25.2; moderate, severe, or blind: 32.9%; 95% CI, 24.1- 41.8), and CS impairment (25.9%; 95% CI, 20.5-31.3). Dementia prevalence was higher among participants with near VI and CS impairment than those without (near VI prevalence ratio: 1.40; 95% CI, 1.16-1.69; CS impairment prevalence ratio: 1.31; 95% CI, 1.04-1.66) and among participants with moderate to severe distance VI or blindness (prevalence ratio: 1.72; 95% CI, 1.26-2.35) after adjustment for covariates. Conclusions and relevance In this survey study, all types of objectively measured VI were associated with a higher dementia prevalence. As most VI is preventable, prioritizing vision health may be important for optimizing cognitive function.
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APA 7th
Killeen, O. J., Zhou, Y., & Ehrlich, JR. (2023). Objectively Measured Visual Impairment and Dementia Prevalence in Older Adults in the US. JAMA ophthalmology. https://doi.org/10.1001/jamaophthalmol.2023.2854
Vancouver
Killeen OJ, Zhou Y, Ehrlich JR. Objectively Measured Visual Impairment and Dementia Prevalence in Older Adults in the US. JAMA ophthalmology. 2023. doi:10.1001/jamaophthalmol.2023.2854. PMID: 37440238.
BibTeX
@article{killeen2023-37440238,
author = {Killeen, O. J. and Zhou, Y. and Ehrlich, JR.},
title = {{Objectively Measured Visual Impairment and Dementia Prevalence in Older Adults in the US}},
journal = {JAMA ophthalmology},
year = {2023},
doi = {10.1001/jamaophthalmol.2023.2854},
pmid = {37440238},
url = {https://doi.org/10.1001/jamaophthalmol.2023.2854}
}
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Key findings
- Results Of 2967 included participants, 1707 (weighted percentage, 55.3%) were female, and the median (IQR) age was 76.9 (77-86) years.
- Conclusions and relevance In this survey study, all types of objectively measured VI were associated with a higher dementia prevalence.
Study details
- Participants3,817
- Effect size55.3%; 12.3%; 21.5%
- Evidence strengthLow
How this study scored 53/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 31 of the 58 points we could judge it on, which is 53 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (JAMA ophthalmology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,817 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 37440238) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 31 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 31 of the 58 points we could judge it on is 53 out of 100. |
| Total | 53 / 100 | — |
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