Abstract

Objectives

To provide a quantitative synthesis of studies on the relationship between vision impairment (VI) and cognitive outcomes in older adults.

Method

A systematic search was undertaken of relevant databases for original articles published before April 2020. Random effect models were used to obtain pooled estimates of the associations between VI and cognitive outcomes (cognitive impairment and dementia) with subgroup analyses of VI measures, cross-sectional associations of VI with cognitive impairment, and longitudinal associations of baseline VI with incident cognitive impairment and dementia. Potential sources of heterogeneity were explored by meta-regression. Publication bias was evaluated with Egger’s test.

Results

Sixteen studies including 76,373 participants were included in this meta-analysis, with five cross-sectional studies and eleven longitudinal studies. There was a significantly increased risk of cognitive outcomes with VI identified by subjective measures (odds ratio (OR)=1.63; 95% confidence interval (CI): 1.26–1.99) and objective measures (OR = 1.59; 95% CI: 1.40–1.78). The odds of baseline cognitive impairment were 137% higher in older adults with VI compared with those without VI (OR = 2.37, 95% CI: 1.84–3.03) at baseline. Compared with older adults without VI at baseline, those with baseline VI had a higher relative risk (RR) of incident cognitive impairment (RR = 1.41; 95% CI: 1.31–1.51) and dementia (RR = 1.44, 95% CI: 1.19–1.75).

Conclusions

VI was associated with increased risks of cognitive impairment and dementia across cross-sectional and longitudinal studies. Additional research and randomized clinical trials are warranted to examine the implications of treatment for VI, such as wearing glasses and cataract surgery, to avoid cognitive impairment and dementia.

中文翻译：

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老年人视力障碍与认知结果之间的关联：系统评价和荟萃分析

摘要

目标

提供关于老年人视力障碍 (VI) 与认知结果之间关系的研究的定量综合。

方法

对 2020 年 4 月之前发表的原始文章的相关数据库进行了系统搜索。使用随机效应模型通过 VI 测量、横截面关联的亚组分析来获得 VI 与认知结果（认知障碍和痴呆）之间关联的汇总估计VI 与认知障碍的关系，以及基线 VI 与事件认知障碍和痴呆的纵向关联。通过元回归探索异质性的潜在来源。发表偏倚通过 Egger 检验进行评估。

结果

该荟萃分析包括 16 项研究，包括 76,373 名参与者，其中包括 5 项横断面研究和 11 项纵向研究。通过主观测量（比值比 (OR)=1.63；95% 置信区间 (CI)：1.26–1.99）和客观测量（OR = 1.59；95% CI：1.40– 1.78). 与基线时没有 VI 的老年人相比，有 VI 的老年人出现基线认知障碍的几率高 137% (OR = 2.37, 95% CI: 1.84–3.03)。与基线时没有 VI 的老年人相比，具有基线 VI 的老年人发生认知障碍事件（RR = 1.41；95% CI：1.31–1.51）和痴呆症（RR = 1.44，95% CI：1.19）的相对风险 (RR) 更高–1.75)。

结论

在横断面和纵向研究中，VI 与认知障碍和痴呆症的风险增加有关。有必要进行额外的研究和随机临床试验来检查治疗 VI 的影响，例如戴眼镜和白内障手术，以避免认知障碍和痴呆。