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Associations between Visual Acuity and Cognitive Decline in Older Adulthood: A 9-Year Longitudinal Study

Published online by Cambridge University Press:  10 December 2021

Ashlyn Runk
Affiliation:
Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, USA
Yichen Jia
Affiliation:
Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, USA
Anran Liu
Affiliation:
Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, USA
Chung-Chou H. Chang
Affiliation:
Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, USA Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, USA
Mary Ganguli
Affiliation:
Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, USA Department of Neurology, University of Pittsburgh, School of Medicine, Pittsburgh, USA Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, USA
Beth E. Snitz*
Affiliation:
Department of Neurology, University of Pittsburgh, School of Medicine, Pittsburgh, USA
*
*Correspondence and reprint requests to: Beth E. Snitz, Department of Neurology, University of Pittsburgh, 3501 Forbes Avenue, Suite 830, Pittsburgh, PA 15213, USA. E-mail: snitzbe@upmc.edu

Abstract

Objective:

Emerging evidence suggests low vision may be a modifiable risk factor for cognitive decline. We examined effects of baseline visual acuity (VA) on level of, and change in, cognitive test performance over 9 years.

Method:

A population-based sample of 1,621 participants (average age 77 years) completed a comprehensive neuropsychological evaluation and VA testing at baseline and reassessed at nine subsequent annual visits. Linear regression modeled the association between baseline VA and concurrent cognitive test performance. Joint modeling of a longitudinal sub-model and a survival sub-model to adjust for attrition were used to examine associations between baseline VA and repeated cognitive test performance over time.

Results:

Better baseline VA was associated cross-sectionally with younger age, male sex, greater than high school education, and higher baseline neuropsychological test scores on both vision-dependent (B coefficient range −0.163 to −0.375, p = .006 to <.001) and vision-independent tests (−0.187 to −0.215, p = .003 to .002). In longitudinal modeling, better baseline VA was associated with slower decline in vision-dependent tests (B coefficient range −0.092 to 0.111, p = .005 to <.001) and vision-independent tests (−0.107 to 0.067, p = .007 to <.001).

Conclusions:

Higher VA is associated with higher concurrent cognitive abilities and slower rates of decline over 9 years in both vision-dependent and vision-independent tests of memory, language, and executive functioning. Findings are consistent with emerging literature supporting vision impairment in aging as a potentially modifiable risk factor for cognitive decline. Clinicians should encourage patient utilization of vision assessment and correction with the added aim of protecting cognition.

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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