Association Between Sensory Impairment and Dementia in Older Adults: Evidence from China

Luo, Yanan; He, Ping; Guo, Chao; Chen, Gong; Li, Ning

doi:10.1111/jgs.15202

Cited by 62 publications

(66 citation statements)

References 26 publications

(30 reference statements)

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“…People with self-reported vision impairment have increased risk of some health conditions such as depression, dementia, cardiovascular disease, and lung cancer. [86][87][88][89] The causal relationship between vision impairment and other conditions is complex, but can be broadly summarised by three different pathways (figure 5); (1) vision impairment causes or exacerbates other conditions either directly, through injuries, or indirectly-eg, through reduced access to health care, limitations in physical activity, or increased social isolation; (2) vision impairment and other conditions share common risk factors-eg, smoking, poverty, reduced health-care access, ageing, or poor diet; and (3) systemic health problems can lead to vision impairment-eg, diabetes and diabetic retinopathy, cancer and ocular metastases, and dementia-limiting access to eye health services.…”

Section: Vision Impairment and Other Health Conditionsmentioning

confidence: 99%

The Lancet Global Health Commission on Global Eye Health: vision beyond 2020

Burton

Ramke

Marques

et al. 2021

The Lancet Global Health

756

572

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Eye health is essential to achieve the Sustainable Development Goals; vision needs to be reframed as a development issue There is extensive evidence showing that improving eye health contributes directly and indirectly to achieving many Sustainable Development Goals, including reducing poverty and improving work productivity, general and mental health, and education and equity. Improving eye health is a practical and cost-effective way of unlocking human potential. Eye health needs to be reframed as an enabling, cross-cutting issue within the sustainable development framework. Almost everyone will experience impaired vision or an eye condition during their lifetime and require eye care services; urgent action is necessary to meet the rapidly growing eye health need In 2020, 1•1 billion people had distance vision impairment or uncorrected presbyopia. By 2050, this figure is expected to rise to 1•8 billion. Most affected people live in low-income and middle-income countries (LMICs) with avoidable causes of vision impairment. During the life course, most people will experience vision impairment, even if just the need for reading glasses. Because of unmet needs and an ageing global population, eye health is a major public health and sustainable development concern which warrants urgent political action. Eye health is an essential component of universal health coverage; it must be included in planning, resourcing, and delivery of health care Universal health coverage is not universal without affordable, high quality, equitable eye care. In line with the WHO World report on vision, we urge countries to consider eye care as an essential service within universal health coverage. To deliver comprehensive services including promotion, prevention, treatment, and rehabilitation, eye care needs to be included in national strategic health plans and development policies, health financing structures, and health workforce planning. Coordinated intersectoral action is needed to systematically improve population eye health, also within healthy ageing initiatives, schools, and the workplace. Integration of eye health services with multiple relevant components of health service delivery and at all levels of the health system is of central importance.

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Section: Vision Impairment and Other Health Conditionsmentioning

confidence: 99%

The Lancet Global Health Commission on Global Eye Health: vision beyond 2020

Burton

Ramke

Marques

et al. 2021

The Lancet Global Health

756

572

View full text Add to dashboard Cite

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“…A patient with a BCVA lower than 0.05 is defined as blind. 23 Therefore, our patients were assigned to three groups according to their BCVA: Group A (BCVA ‡ 0.5), Group B (BCVA ‡ 0.05 to < 0.5), and Group C (BCVA < 0.05). Healthy individuals with a BCVA of 1.0, spherical refraction < 3 D, no other ocular diseases, and no history of eye surgery were enrolled as a normal control.…”

Section: Participants and Examinationsmentioning

confidence: 99%

Effect of Choroidal Vessel Density on the Ellipsoid Zone and Visual Function in Retinitis Pigmentosa Using Optical Coherence Tomography Angiography

Liu

Lü

Liu

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We evaluate the effect of choroidal vessel density on the residual length of the ellipsoid zone (EZ) and visual function in patients with retinitis pigmentosa (RP) using optical coherence tomography angiography (OCTA). METHODS. Fifty-three patients with RP (n ¼ 101 eyes) and 53 normal participants (n ¼ 76 eyes) were enrolled in this study. Patients with RP were assigned to three groups according to their best-corrected visual acuity (BCVA). All patients underwent ophthalmologic examinations, including BCVA, fundus examination performed with a slit-lamp using an indirect 90 diopter (D) lens, OCTA, full-field electroretinogram (ERG), and visual field. The choroidal vessel density in the choriocapillaris-Sattler's layer (D C-S), Haller's layer (D H), horizontal length of the ellipsoid (HEL), and vertical length of the ellipsoid (VEL) were assessed using OCTA and Adobe Photoshop CS3 extended software. RESULTS. A significantly increasing impairment of choroidal vessel density (D C-S and D H) was characterized in the RP groups compared to those of the controls (P < 0.05 for all). The magnitude of the reduction in the DC-S and DH was much easier to identify for more severely impaired BCVA in the RP groups (P < 0.05 for all). The D C-S had the strongest correlation with the HEL, VEL, BCVA, visual field, and b-wave amplitude (r ¼ 0.735, r ¼ 0.753, r ¼ À0.843, r ¼ 0.579, and r ¼ 0.671, respectively). CONCLUSIONS. Using noninvasive OCTA, choroidal microcirculation, especially in the small/ middle choroidal vessel layers, was a prominent factor affecting the EZ, visual acuity, visual field, and recordable ERG b-wave amplitude of patients with RP. This may provide new insights into the progress mechanism and treatment of RP.

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“…Diabetic retinopathy and neuropathy cause severe sensory impairments in older patients with T2D; furthermore, T2D has been associated to increased risk of bilateral sensorineural hearing loss in addition to established microvascular damage, which might contribute to further sensory loss [ 24 , 25 ]. Sensory impairments, particularly in eyesight, hearing, and neuropathy have been associated with increased dementia risk and favor the development of disability and increased mortality; in addition, end-organ microvascular damage in T2D increases risk of falls and impairment of functional status [ 26 , 27 ]. The role of microvascular damage in the pathophysiology of dementia in diabetes has also been studied, but the evidence of this association is inconsistent and neurological changes have been observed in individuals with T2D without end-organ microvascular damage [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

The type 2 diabetes-specific dementia risk score (DSDRS) is associated with frailty, cognitive and functional status amongst Mexican community-dwelling older adults

2020

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Background The type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D. T2D-related factors have been shown increase the risk of age-related conditions, which might also increase dementia risk. Here, we investigate the associations of DSDRS with frailty, disability, quality of life (QoL) and cognition in community-dwelling older adults with T2D. Methods We included 257 community-dwelling older adults with T2D to evaluate the association between DSDRS and Mini-mental state examination (MMSE), Isaac’s set-test (IST), clock drawing test (CDT), quality of life (SF-36), risk of malnutrition (Mini-Nutritional Assessment or MNA), as well as frailty, Katz’ and Lawton-Brody scores. We also assessed the phenotype and correlates of high-estimated dementia risk by assessing individuals with DSDRS >75th age-specific percentiles. Results Mean age of participants was 78.0 ± 6.2 years. DSDRS showed a significant correlation with MMSE test, IST, CDT, SF-36, MNA, Lawton-Brody and Katz scores, and an increasing number of frailty components. DSDRS was higher among frail, pre-frail, and subjects with limited ADL and IADL (p < 0.001). Participants with DSDRS >75th age-specific percentiles had lower education, MMSE, IST, SF-36, MNA, Katz, Lawton-Brody, and higher frailty scores. High-estimated 10-year dementia risk was associated with ADL and IADL disability, frailty and risk of malnutrition. When assessing individual components of DSDRS, T2D-related microvascular complications were associated to all outcome measures. Conclusion The DSDRS is associated with frailty, disability, malnutrition and lower cognitive performance. These findings support that T2D-related factors have significant burden on functional status, QoL, disability and dementia risk.

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Association Between Sensory Impairment and Dementia in Older Adults: Evidence from China

Abstract: Sensory impairments are associated with greater risk of dementia in Chinese older adults. Studies are needed to further explore the pathway of this association in Chinese elderly adults and to provide suggestions to improve health status for this population.

Cited by 62 publications

References 26 publications

The Lancet Global Health Commission on Global Eye Health: vision beyond 2020

The Lancet Global Health Commission on Global Eye Health: vision beyond 2020

Effect of Choroidal Vessel Density on the Ellipsoid Zone and Visual Function in Retinitis Pigmentosa Using Optical Coherence Tomography Angiography

The type 2 diabetes-specific dementia risk score (DSDRS) is associated with frailty, cognitive and functional status amongst Mexican community-dwelling older adults

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