Mary A.M. Rogers, PhD
Mary A.M. Rogers, PhD, research director, Patient Safety Enhancement Program, University of Michigan Health System, Ann Arbor. Her study was published in BMC Medicine.
Seeds for this study were planted with information from the Aging, Demographics, and Memory Study, when University of Michigan researchers noticed that people with dementia tended to have had fewer eye procedures prior to their diagnoses than those without dementia. This led the team to ask two questions…
Using data from Medicare and the nationally representative Health and Retirement Study, the Michigan researchers followed 625 elderly Americans (none of whom had dementia at the outset) for an average of 10 years. Based on a scale that ranked vision from excellent (one) to totally blind (six), they found that the risk for dementia increased 52%, on average, with each step up the scale. Mary A.M. Rogers, PhD, a clinical epidemiologist and the study’s lead author, said that the study results suggest that the problems with declining vision preceded the dementia. She said that this is the first epidemiologic study, to her knowledge, that points to treatment of vision problems as being protective against the development of late-life dementia.
Some of the connections between poor vision and dementia symptoms seem obvious, while others are not yet understood. For instance, Dr. Rogers pointed out that people with poor vision may be less likely to participate in the kinds of activities, such as reading, playing board games and engaging in physical activities, that can be protective against cognitive decline. She said that other research indicates that visual loss can lead to structural changes in the brain, but notes that more studies are needed to understand why.
Good news came out of this study too. Dr. Rogers told me that when elderly people received appropriate treatment for their visual difficulties — which can include procedures such as corneal transplant, cataract removal and lens insertion, and treatment for retinal detachment, lesions and other eye disorders — their probability of developing dementia decreased. Even one visit to an ophthalmologist was associated with a lower risk.
Unfortunately, at this point Medicare coverage of vision problems is spotty. While only about 13% of the Medicare population has Alzheimer’s disease, this group accounts for 34% of Medicare spending — and, of course, Alzheimer’s incidence is increasing, not declining. Dr. Rogers believes it would be very worthwhile to investigate whether expanding vision screenings and treatment to more elderly Americans would in fact save money for Medicare. In the meantime, it is wise to visit your doctor if you are having any vision problems — it may improve your health and your life in several important ways.