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. 2024 Apr 30;14(4):e072626.
doi: 10.1136/bmjopen-2023-072626.

Effect of visual impairment on subjective cognitive decline in older adults: a cross-sectional study in China

Liyan Luo  1   2 , Ning Jiang  1   3 , Xiaolei Zheng  4 , Ping Wang  4 , Jianzhong Bi  4   5 , Feng Xu  6 , Zhaohong Xie  7 , Liping Yang  8
Affiliations

Effect of visual impairment on subjective cognitive decline in older adults: a cross-sectional study in China

Liyan Luo et al. BMJ Open. .

Abstract

Objective: People with visual impairment have more functional limitations associated with subjective cognitive decline (SCD), and those with SCD are extremely susceptible to transitioning to irreversible cognitive impairment. This study aimed to explore if visual impairment is a significant predictor of SCD compared with other socioeconomic and health factors associated with SCD.

Design: Cross-sectional study.

Setting and participants: The investigation aimed to assess the factors influencing SCD among 428 participants aged 60 and above in Zhaoyuan, China.

Primary outcome measures: The primary outcome variable was SCD, measured by the Chinese version of SCD questionnaire. Multiple logistic regression and propensity score matching (PSM) were used to analyse the influence of visual impairment on the subjective cognition of the elderly.32.2% of the elderly were experiencing SCD. Older adults with SCD showed a higher prevalence of visual impairment (72.5%) than the elderly without SCD (58.6%) (P=0.006). Multivariate logistic regression analysis showed that bad self-reported health status, lack of physical exercise and visual impairment were the risk factors for SCD in older adults, while more than 9 years of education was a protective factor. In addition, PSM model showed that after eliminating the dominant biases caused by the individual observable heterogeneity of older adults with and without visual impairment, the risk of SCD in the elderly with visual impairment was increased by 13.6%-14.5% and the difference was statistically significant (P<0.05).

Conclusions: It was found that older adults experiencing visual impairments are at an elevated risk of developing SCD compared with their counterparts without such impairments. Additionally, visual impairment remains a significant risk factor for SCD in the elderly, even adjusting for potential biases arising from individual observable heterogeneity.

Keywords: aged; geriatric medicine; quality in health care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Standardisation percent difference of covariates before and after matching.
Figure 2
Figure 2
Nuclear density diagrams of the treatment group and the control group before matching.
Figure 3
Figure 3
Nuclear density diagrams of the treatment group and the control group after matching.
Figure 4
Figure 4
Propensity scores of PSM between the visual impairment and non-visual impairment groups. PSM, propensity score matching.
See this image and copyright information in PMC

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