Vision Loss Linked toCognitivedecline among the Elderly

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An LVPEI research team identifies a strong association between cognitive impairment and vision impairment among those over 60 years old and live in homes for the aged1 in 4 had cognitive decline and those with vision loss had 4x chance of dementia. The paper is part of the Hyderabad Ocular Morbidity in the Elderly Study (HOMES).

Hyderabad, July 2024: A new paper published in BMJ Open Access by public health specialists at the L V Prasad Eye Institute (LVPEI), along with their international collaborators, unravels the high prevalence of cognitive impairment among elderly with vision loss. The paper found that 1 out of 4 elderly are living with cognitive impairment. In fact, those with vision loss had a 4x chance of cognitive impairment when compared to those without vision loss. The paper also found that those older persons who had worse vision were more likely to be cognitively impaired. Similarly, cognitive impairment affected one out of every four individuals with near vision impairment.

While less than 30% of elderly with mild vision impairment had cognitive impairment, this percentage steadily increases as vision impairment worsens. The study included 15 people with blindness and 60% of them exhibited measurable signs of cognitive decline. Similarly, mental decline also increased with age. Women consistently have a higher prevalence of cognitive impairment, and this study found that women were 2x likely to be cognitively impaired than men. Severe forms of cognitive impairment leads to dementia. 

The study’s results suggest that addressing vision loss may be key to arresting dementia and other forms of cognitive decline in India’s elderly population.

“The results exhibit a strong association between vision loss and cognitive loss,” said Dr. Srinivas Marmamula, Scientist and public health researcher at LVPEI. “While more and more elderly are living in homes for aged, we have very little evidence-based policy interventions that can help improve their lives and conserve their quality of life. This paper builds a case for screening them for vision and cognitive loss. A pair of glasses or safe cataract surgery can go a long way in helping our elderly live independent and fulfilling lives in their sunset years.”

This paper is part of 16 papers published as part of the Hyderabad Ocular Morbidity in the Elderly Study (HOMES) led by Dr. Marmamula funded by Wellcome Trust/DB India Alliance. HOMES covers over 1,500 elderly participants (those 60 years old and above) who live in care homes for the aged in Hyderabad. This paper includes 965 of that set, and just over 60% of them were women. About 27% of the participants had cognitive impairment. The study included Dr Suvarna Alladi, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India, Dr. David Bloom from Harvard University, Dr. David Friedman from HarvardMedical School and Dr. Joshua Ehrlich from University of Michigan in USA as co-authors.

Editor’s notes

HOMES: The Hyderabad Ocular Morbidity in the Elderly Study is one of the most comprehensive eye health studies done among the elderly living in homes for the aged in India. It included 1,515 participants from over 41 homes for the aged. The study has a large sample size, and comprehensive eye examination including visual acuity assessment and use of a standard questionnaire to assess cognition are central to this study.

Read the paper herehttps://bmjopen.bmj.com/content/14/7/e084348

About LVPEI: Established in 1987, L V Prasad Eye Institute (LVPEI), a World Health Organization Collaborating Centre for Prevention of Blindness, is a comprehensive eye health facility. The Institute has ten functional arms to its areas of operations: Clinical Services, Education, Research, Vision Rehabilitation, Rural and Community Eye Health, Eye Banking, Advocacy and Policy Planning, Capacity Building, Innovation, and Product Development. The LVPEI Eye Care Network has 308 Centres spread across Telangana, Andhra Pradesh, Odisha, and Karnataka in India. The institute’s mission is to provide equitable and quality eye care to all sections of society. The LVPEI’s five-tier ‘Eye Health Pyramid’ model, covering all areas of the community right from the villages to the city, provides high quality and comprehensive – prevention, curative, and rehabilitation – eye care to all. It has offered over 36.89 millionconsultations, with more than 50% entirely free of cost, irrespective of the complexity of care needed.

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