Effect of cataract surgery on cognition, mood, and visual hallucinations in older adults

Abstract

Purpose: To assess the impact of cataract surgery on cognition, mood, and visual hallucinations in a cohort of patients aged 75 years and older.

Setting: Secondary care ophthalmology unit in Northeast England.

Design: Prospective observational cohort study.

Methods: Participants aged 75 years or older with bilateral cataract and scheduled for cataract surgery were recruited consecutively. Participants were assessed preoperatively and followed for 1 year postoperatively. Cognition was assessed using the revised Addenbrooke's Cognitive Examination (ACE-R), mood was measured with the 15-item Geriatric Depression Scale, visual hallucinations were elicited using the North East Visual Hallucinations Inventory, and visual acuity was assessed using a logMAR chart.

Results: One hundred twelve participants were recruited at baseline; 91 (81%) completed 1 year of follow-up. Significant improvements in ACE-R scores were seen between baseline and 1 year postoperatively (95% confidence interval for improvement, 0.5-2.8; P = .005). Improved cognition did not correlate with improved visual acuity (r = -0.13, P = .22). No significant changes in mood were seen during the course of the study (P = .314, repeated-measures 1-way analysis of variance). Complete resolution of complex visual hallucinations occurred in 2 patients after surgery.

Conclusions: Small improvements in cognition and reports of resolved complex visual hallucinations indicate that the benefits of cataract surgery might extend beyond visual improvement.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.