Visual impairment and its association with cognitive impairment: the Handan Eye Follow-up Study

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AIMS: To investigate the association between visual impairment (VI) and cognitive impairment in middle-aged and older adults from a rural Chinese population. METHODS: The Handan Eye Follow-up Study was conducted between 2012 and 2013. All participants underwent a standardised ophthalmic examination, structured interview and mobility performance assessment. The ophthalmic examination included visual acuity (VA) measurement and a comprehensive clinical eye examination. The interview collected demographic characteristics, cognitive status assessed by the Mini-Mental State Examination (MMSE) and general information related to medical conditions. Mobility performance was evaluated using walking speed tests, standing balance tests and the Timed Up and Go Test. RESULTS: Of the 5394 participants in the Handan Eye Follow-up Study, 3794 were aged ≥50 years, of whom 3650 completed both VA and cognitive assessments. The prevalence of distance VI and near VI was 27.53% and 91.99%, respectively. Linear regression analyses revealed that distance VI was associated with a 1.53-fold higher likelihood of poorer MMSE scores after adjustment for demographic variables (p<0.01); however, this association was not statistically significant after further adjustment for all covariates (p=0.23). Near VI was associated with a 2.21-fold higher likelihood of poorer MMSE scores following initial adjustment (p=0.025), and this association remained significant after full adjustment (OR= 3.44, p=0.028). CONCLUSIONS: Near VI was associated with poorer cognitive performance in a rural Chinese population of middle-aged and older adults, highlighting the potential role of correctable vision loss in cognitive health.

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