ABSTRACT

Purpose

To examine the longitudinal association between vision-related variables and the 3-year change in cognitive test scores in a community-dwelling sample of adults and to explore whether sex, education, or hearing loss act as effect modifiers.

Methods

Data came from two waves of a 3-year population-based prospective cohort study (Canadian Longitudinal Study on Aging), which consisted of 30,097 randomly selected people aged 45–85 years from 7 Canadian provinces. Visual impairment (VI) was defined as binocular presenting visual acuity worse than 20/40. Participants were asked if they had ever had a diagnosis of age-related macular degeneration (AMD), glaucoma, or cataract. Cognitive change over 3 years was examined by calculating the difference between baseline and follow-up scores for the Rey Auditory Verbal Learning Test (RAVLT) and the RAVLT delayed test (memory tests), the Controlled Oral Word Association Test (COWAT) and the Animal Naming Test (ANT) (verbal fluency tests), and the Mental Alternation Test (MAT) (processing speed test). Multiple linear regression was used.

Results

VI, AMD, and cataract were not associated with 3-year changes on any of the 5 cognitive tests after adjusting for age, sex, ethnicity, education, income, smoking, diabetes, stroke, heart disease, and province. A report of glaucoma was associated with greater declines in MAT scores (β = -0.60, 95% CI -1.03, -0.18). No effect modification was detected.

Conclusions

Glaucoma was associated with worsening processing speed. Further research to confirm this finding and to understand the possible reason is necessary.

中文翻译：

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视力障碍、眼病和 3 年认知衰退：加拿大老龄化纵向研究

摘要

目的

在社区居住的成年人样本中检查视力相关变量与认知测试分数的 3 年变化之间的纵向关联，并探讨性别、教育或听力损失是否作为效应调节剂。

方法

数据来自两波为期 3 年的基于人群的前瞻性队列研究（加拿大老龄化纵向研究），该研究由来自加拿大 7 个省的 30,097 名年龄在 45-85 岁的随机选择的人组成。视力障碍 (VI) 定义为双眼呈现视力低于 20/40。参与者被问及是否曾被诊断为年龄相关性黄斑变性 (AMD)、青光眼或白内障。通过计算 Rey 听觉语言学习测试 (RAVLT) 和 RAVLT 延迟测试（记忆测试）、受控口语联想测试 (COWAT) 和动物的基线和后续分数之间的差异来检查 3 年的认知变化命名测试（ANT）（语言流利度测试）和心理交替测试（MAT）（处理速度测试）。使用多元线性回归。

结果

在调整年龄、性别、种族、教育、收入、吸烟、糖尿病、中风、心脏病和省份后，VI、AMD 和白内障与 5 项认知测试中任何一项的 3 年变化均无关。青光眼报告与 MAT 分数的更大下降有关（β = -0.60, 95% CI -1.03, -0.18）。未检测到效果修饰。

结论

青光眼与处理速度恶化有关。有必要进一步研究以证实这一发现并了解可能的原因。