Cognitive Function and Ophthalmological Diseases: The Beijing Eye Study

Jost B Jonas,Li Ping Zhu,Ya Xing Wang,Liang Xu,Wen Bin Wei

doi:10.1038/s41598-018-23314-5

Abstract

To examine associations between cognitive function and ophthalmological parameters, the population-based Beijing Eye Study examined ophthalmologically and physically 3127 individuals (mean age: 64.2 ± 9.8 years). Using the mini–mental state examination, cognitive function was assessed as cognitive function score (CFS). Mean CFS was 26.3 ± 3.7 (median: 27; range: 2–30). Prevalence of mild (CFS: 23–19), moderate (CFS: 18–10) and severe cognitive dysfunction was 9.6% (95% confidence interval (CI): 8.5, 10.6), 3.2% (95% CI: 2.6, 3.9) and 0.6% (95% CI: 0.4,0.9), respectively. In multivariate analysis, better cognition (i.e., higher CFS) was significantly associated with better best corrected visual acuity (r2 = 0.38), smaller amount of undercorrected visual acuity, lower prevalence of primary angle-closure glaucoma, and thicker subfoveal choroidal thickness. Prevalence of age-related macular degeneration, open-angle glaucoma, diabetic retinopathy, any type of cataract, retinal vein occlusions or pseudoexfoliation was not significantly correlated with CFS. Though the causal relationship is unclear, the associations of lower cognitive function with undercorrected visual acuity suggest the need for earlier and more regular refraction testing in the elderly so that providing adequate glasses to the elderly can be provided and vision-associated cognitive decline can be reduced. Associations of cognitive function with primary angle-closure glaucoma and leptochoroid should be further explored.

Highlights

To examine associations between cognitive function and ophthalmological parameters, the populationbased Beijing Eye Study examined ophthalmologically and physically 3127 individuals
Our population-based study performed in a rural area and an urban region of Greater Beijing revealed a prevalence of mild cognitive dysfunction of 9.6%, of moderate cognitive dysfunction of 3.2%, and of severe cognitive dysfunction of 0.6% (Figs 2, 3)
Higher cognitive function correlated with younger age, higher level of education, rural region of habitation, lower depression score, higher physical activity, better best corrected visual acuity, Parameter Age (Years) Level of Education Region of Habitation (Rural/Urban) Depression Score Physical Activity (“How Many Days Do You Do Moderate-Intensive Sports or Similar Activities?”) Presenting Visual Acuity Best Corrected Visual Acuity Primary Angle-Closure Glaucoma Fundus Tessellation

Summary

Introduction

To examine associations between cognitive function and ophthalmological parameters, the populationbased Beijing Eye Study examined ophthalmologically and physically 3127 individuals (mean age: 64.2 ± 9.8 years). Except for associations of retinal microvascular abnormalities, early age-related macular degeneration or visual loss with cognitive impairment, correlations between cognitive dysfunction and ocular parameters or ophthalmological diseases have usually not been examined in a systematic manner, yet[5,6,7,8,9,10,11,12,13]. The knowledge about such associations may be useful to better understand the factors leading to cognitive impairment and vice versa, to better assess how cognitive dysfunction may influence the development and progression of ocular diseases, e.g. by changing the adherence to the recommended therapy. We conducted this study to examine the prevalence of a reduced cognitive function in a populations living in an urban or rural region of Greater Beijing and to asses potential associations between cognitive dysfunction and ocular variables[14,15,16,17]

Methods

Results

Conclusion