Abstract
Recent studies suggested that an association exists between vision loss and cognitive impairment, although it is still vague whether there are causal relationships or direct association between low vision and dementia. We were to investigate the association between low vision and dementia in the Korean population using the National Health Insurance Service (NHIS) database. We analyzed the data of 6,029,657 subjects aged ≥40 years, drawn from Korea National Health Insurance Service. The hazard ratio (HRs) and 95% confidence interval (CIs) of dementia, Alzheimer’s disease (AD), and Vascular dementia (VD) were estimated using multivariable Cox proportional hazards regression models. Statistical analysis showed that subjects with more severe visual impairments have a higher risk of dementia, AD, and VD after adjusting for compounding variables. The HRs of dementia increased significantly as visual acuity worsened (HRs 1.444 [95% CIs 1.415–1.473] for visual acuity (VA) < 1.0, 1.734 [1.693–1.777] for VA < 0.3, 1.727 [1.686–1.770] for VA < 0.1 and 1.991[1.902–2.085] for visual loss). Baseline visual loss and visual impairment were positively associated with the risk of dementia, AD, and VD. From the results of this nationwide population-based cohort study, we suggest that there is a significant increase in the incidence of dementia in subjects with low vision.
Highlights
Recent studies suggested that an association exists between vision loss and cognitive impairment, it is still vague whether there are causal relationships or direct association between low vision and dementia
Alzheimer’s disease, and vascular dementia according to severity of visual loss and visual impairment
Any other interactions of dementia with age, sex, exercise, hypertension, and lipid levels were not shown in the development of dementia, Alzheimer’s disease (AD), and vascular dementia (VD). In this longitudinal nationwide study, we analyzed the risk of incident AD and VD according to visual function
Summary
Recent studies suggested that an association exists between vision loss and cognitive impairment, it is still vague whether there are causal relationships or direct association between low vision and dementia. Recent studies reported that the incidence of dementia in western countries may be declining whereas low and middle income countries are predicted to have the largest increase in incident dementia[8,11]. This discrepancy is suggested to be due to the differences in the effective management of cardiovascular disease, hypertension, and diabetes in these regions[8]. Number Sex (Male) Place(urban) Hypertension Diabetes Lipid Exercise Smoking No Past Current Drinking level No Mild Heavy Income (low) Age (Mean ± SD) BMI WC Glucose Systolic blood pressure Diastolic blood pressure HDL LDL Age (Median, range)
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