Roles of Cognitive Function on Visual Field Reliability Indices among Glaucoma Patients

Abstract

This study reports the prevalence of cognitive impairment (CI) in patients attending a glaucoma outpatient clinic at a tertiary hospital. It also comprehensively assesses possible associations between CI and visual field (VF) reliability indices among glaucoma patients. The retrospective analysis included 1464 eyes from 746 subjects (mean age, 70.6 ± 11.9; 401 males and 345 females). CI was evaluated using the Mini-Cog test, revealing a suspected prevalence of 8.0% (60 out of 746) among the patients. After adjusting for various background parameters using a mixed effects regression model, an abnormal Mini-Cog score was linked to higher false negative (FN) (p = 0.0034) and false positive (FP) (p = 0.0051) but not fixation loss (FL) (p = 0.82). Among the Mini-Cog components, a lower word recall test score was associated with higher FN (p < 0.0001), with a borderline difference in FP (p = 0.054) and no significant effect on FL (p = 0.09). Conversely, a lower clock drawing test score was associated with higher FP (p = 0.038), while FL (p = 0.49) and FN (p = 0.12) remained unaffected. These findings suggest that CI can impact the reliability of VF testing among glaucoma patients, highlighting the importance of assessing cognitive function in glaucoma care.