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. 2020 Jun 4;10(1):9109.
doi: 10.1038/s41598-020-66002-z.

Low vision and the risk of dementia: a nationwide population-based cohort study

Ji-Sun Paik  1 , Minji Ha  1 , Youn Hea Jung  1 , Gee-Hyun Kim  1 , Kyung-Do Han  2 , Hyun-Seung Kim  1 , Dong Hui Lim  3 , Kyung-Sun Na  4
Affiliations

Low vision and the risk of dementia: a nationwide population-based cohort study

Ji-Sun Paik et al. Sci Rep. .

Abstract

Recent studies suggested that an association exists between vision loss and cognitive impairment, although it is still vague whether there are causal relationships or direct association between low vision and dementia. We were to investigate the association between low vision and dementia in the Korean population using the National Health Insurance Service (NHIS) database. We analyzed the data of 6,029,657 subjects aged ≥40 years, drawn from Korea National Health Insurance Service. The hazard ratio (HRs) and 95% confidence interval (CIs) of dementia, Alzheimer's disease (AD), and Vascular dementia (VD) were estimated using multivariable Cox proportional hazards regression models. Statistical analysis showed that subjects with more severe visual impairments have a higher risk of dementia, AD, and VD after adjusting for compounding variables. The HRs of dementia increased significantly as visual acuity worsened (HRs 1.444 [95% CIs 1.415-1.473] for visual acuity (VA) < 1.0, 1.734 [1.693-1.777] for VA < 0.3, 1.727 [1.686-1.770] for VA < 0.1 and 1.991[1.902-2.085] for visual loss). Baseline visual loss and visual impairment were positively associated with the risk of dementia, AD, and VD. From the results of this nationwide population-based cohort study, we suggest that there is a significant increase in the incidence of dementia in subjects with low vision.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan-Meier cumulative probability curve for the incidence of dementia in patients with visual impairments. Dementia means overall dementia and is subcategorized as Alzheimer disease and vascular dementia. The top row (A–C) compares the subjects with visual loss with subjects without visual loss; subjects with visual loss show more increased incidence probability of dementia, AD, and VD than subjects without visual loss. The bottom row (D–F) compares subgroups according to visual impairments, and subjects with more severe visual impairments have more increased incidence probability of dementia, AD, and VD than subjects with less severe visual impairments.
Figure 2
Figure 2
Enrolment flowchart for the study population.
See this image and copyright information in PMC

References

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