Chen SP et al. – This cross–sectional analysis evaluated the association of measured and self–reported visual impairment (VI) with cognition in a representative sample of older US adults. Both the distance VI and self–reported VI were associated with poor cognitive function. This was also validated by US Medicare beneficiaries reinforcing the value of identifying patients with visual compromise.

Methods

• Measurement of vision was carried out at distance, near, and by self–report in the National Health and Nutrition Examination Survey (NHANES) and by self–report alone in the National Health and Nutrition Examination Survey (NHATS).
• The NHANES measured Digit Symbol Substitution Test (DSST) score and relative DSST impairment (DSST score ≤28, lowest quartile in study cohort).

Results

• In the NHANES data, both distance VI (β=-5.1) and subjective VI (β=-5.3) were associated with lower DSST scores and higher odds of DSST impairment after full adjustment with covariates, whereas, near VI was associated with lower DSST scores but not higher odds of DSST impairment.
• In the NHATS data, all vision variables were associated with higher odds of dementia after full adjustment for cofounders (distance VI: odds ratio [OR], 1.9; near VI: OR, 2.6; either distance or near VI: OR, 2.1).