Objective: Emerging evidence suggests low vision may be a modifiable risk factor for cognitive decline. We examined effects of baseline visual acuity (VA) on level of, and change in, cognitive test performance over 9 years. Method: A population-based sample of 1,621 participants (average age 77 years) completed a comprehensive neuropsychological evaluation and VA testing at baseline and reassessed at nine subsequent annual visits. Linear regression modeled the association between baseline VA and concurrent cognitive test performance. Joint modeling of a longitudinal sub-model and a survival sub-model to adjust for attrition were used to examine associations between baseline VA and repeated cognitive test performance over time. Results: Better baseline VA was associated cross-sectionally with younger age, male sex, greater than high school education, and higher baseline neuropsychological test scores on both vision-dependent (B coefficient range −0.163 to −0.375, p = .006 to <.001) and vision-independent tests (−0.187 to −0.215, p = .003 to .002). In longitudinal modeling, better baseline VA was associated with slower decline in vision-dependent tests (B coefficient range −0.092 to 0.111, p = .005 to <.001) and vision-independent tests (−0.107 to 0.067, p = .007 to <.001). Conclusions: Higher VA is associated with higher concurrent cognitive abilities and slower rates of decline over 9 years in both vision-dependent and vision-independent tests of memory, language, and executive functioning. Findings are consistent with emerging literature supporting vision impairment in aging as a potentially modifiable risk factor for cognitive decline. Clinicians should encourage patient utilization of vision assessment and correction with the added aim of protecting cognition.
Study Objectives Shift work is associated with compromised cognitive function, and with chronic exposure, may place shift workers at elevated risk for dementia. However, evidence of cognitive impairment among former night shift workers is mixed, possibly due to inconsistencies regarding retirement status, work history classification, and cognitive assessments. To address these limitations, this study compared neurocognitive function between retired night shift workers and retired day workers using a well-characterized sample and a rigorous neurocognitive test battery. Methods Participants (N = 61; mean age: 67.9 +/- 4.7 years; 61% females; 13% non-White) were 31 retired day workers and 30 retired night shift workers equated on age, sex, race/ethnicity, premorbid IQ, years retired, and diary-assessed habitual sleep characteristics. Participants completed a neurocognitive battery assessing 6 cognitive domains (language, visuospatial ability, attention, immediate and delayed memory, executive function) and self-reported cognitive function. Linear regression models compared groups on individual cognitive domains, adjusting for age, sex, race/ethnicity, education level, and habitual sleep quality. Results Retired night shift workers scored lower than retired day workers on attention (B = -0.38, 95% CI [-0.75, -0.02], p = .040) and executive function (B = -0.55, 95% CI [-0.92, -0.17], p = .005). In post-hoc analyses, attention and executive function were unrelated to diary-assessed habitual sleep characteristics (disruption, timing, irregularity) in retired night shift workers. Conclusions The observed cognitive weaknesses in retired night shift workers may suggest increased risk for future dementia. Retired night shift workers should be followed to determine whether observed weaknesses progress.
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