Abstract P288: Association Between Vision Impairment and Cognitive Decline in Older Adults With Stroke: Health and Retirement Study

Abstract

Introduction: Nearly 800,000 people in the United States sustain a stroke each year. Up to 60% of stroke survivors have visual impairments and/or ocular deficits, which may negatively impact functional performance, quality of life, and increase the risk for depression. Poor vision has been associated with cognitive decline in older adults, but little is known if vision impairment is a risk factor for cognitive decline among older adults who have survived a stroke. The purpose of this study was to evaluate the association between vision impairment and cognitive decline among stroke survivors and compare the cognitive trajectories of stroke survivors with and without visual impairment. Methods: We used data from four waves (2010-2016) of the Health and Retirement Study to investigate the cognitive health of stroke survivors with and without visual impairment. Vision (excellent-very good [ref], good, fair-poor) and stroke diagnosis were self-reported. Cognition was measured using the Telephone Interview for Cognitive Status. Linear mixed effects regression was used to model the association between overall, near, and far vision and change in cognitive function, adjusting for confounders. Results: The final sample included 1,475 stroke survivors. A majority were female (55.6%) and white (66.3%) and the mean age was 71.0 (11.7). Fair-poor overall ( B =-1.30, p <0.01), near ( B =-1.53, p <0.001), and far ( B =-1.27, p <0.001) vision, as well as good near ( B =-0.82, p <0.001) and far ( B =-0.48, p <0.05) vision were associated with significantly lower baseline cognitive function compared to excellent-very good vision. The association between self-rated vision and cognition decline was not statistically significant. Conclusions: We found that people with worst vision had lower cognitive functioning but not greater cognitive decline than stroke survivors with excellent-to-very good vision. Further research should investigate if specific types of vision impairment potentiate the risk of cognitive impairment and dementia in stroke survivors.