Vision Impairment and Risk of Dementia: Findings from the English Longitudinal Study of Ageing
Vision Impairment and Risk of Dementia: Findings from the English Longitudinal Study of Ageing
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DOI：
10.1111/jgs.15456
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发表时间：
2018-09-01
影响因子：
6.3
通讯作者：
Steptoe, Andrew
中科院分区：
文献类型：
--
作者：
Davies-Kershaw, Hilary R.;Hackett, Ruth A.;Steptoe, Andrew
目的：确定视觉障碍是否与痴呆在横断面和纵向上独立相关。回顾性队列研究。背景参与者：英国老龄化纵向研究。测量结果分析了自评视力（差或盲、中等、正常）与痴呆之间的横断面关联，并使用多变量logistic回归对潜在混杂因素（性别、财富、教育、心血管危险因素）进行了调整。我们还利用Cox比例风险回归对50 - 69岁和70岁及以上的个体进行了平均11年的随访，建立了视力障碍和痴呆之间经调整的纵向关联模型。在对混杂因素进行调整后，将自己的视力评为中度的参与者患痴呆症的可能性是视力正常者的2.0倍（95%置信区间(CI)=1.4-3.1），而将自己的视力评为较差的参与者患痴呆症的可能性是4.0倍（95% CI=2.6-6.1）。纵向上，年龄在50到69岁之间，视力为中等（1.8,95% CI=1.0-3.0）或较差（3.6,95% CI=1.1-11.8）的人比视力正常的人患痴呆症的风险更大。70岁及以上人群的风险无显著差异。结论：我们的研究证实并扩展了其他国家的研究结果，在英国所有50岁及以上的参与者中，显示了中度和低度自评视力与痴呆之间的横断面关联，并在50至69岁的参与者中纵向研究了11年。这些结果有助于确立视力丧失是痴呆的风险因素，尽管原因尚不清楚。需要进行研究来确定视力丧失的筛查和治疗是否可以减缓认知能力下降。
ObjectivesDesignTo determine whether vision impairment is independently associated cross-sectionally and longitudinally with dementia.Retrospective cohort study.SettingParticipantsEnglish Longitudinal Study of Ageing.Individuals aged 50 and olderMeasurementsResultsCross-sectional association between self-rated vision (poor or blind, moderate, normal) and dementia was analyzed, adjusting for potential confounders (sex, wealth, education, cardiovascular risk factors) using multivariable logistic regression. We also modelled the adjusted longitudinal association between vision impairment and dementia over an average of 11 years of follow-up using Cox proportional hazards regression for individuals aged 50 to 69 and those aged 70 and older.After adjustment for confounders, participants who rated their vision as moderate were 2.0 (95% confidence interval (CI)=1.4-3.1) times as likely as those with normal vision to have dementia, and those who rated their vision as poor were 4.0 (95% CI=2.6-6.1) times as likely. Longitudinally, individuals aged 50 to 69 who rated their vision as moderate (1.8, 95% CI=1.0-3.0) or poor (3.6, 95% CI=1.1-11.8) were at greater risk of developing dementia than those who rated their vision as normal. There was no significant difference in risk in those aged 70 and older.ConclusionOur study confirms and extends findings from other countries, demonstrating cross-sectional associations between moderate and poor self-rated vision and dementia in England in all participants aged 50 and older and longitudinally over an 11-year period in those aged 50 to 69. These results help establish vision loss as a risk factor for dementia, although it is unclear why. Research is needed to determine whether screening and treatment for vision loss may slow cognitive decline.