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Cited by 54Dementia and Cognitive Impairment ResearchOphthalmology and Visual Impairment StudiesRetinal Diseases and Treatments

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

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Paik, Ji-Sun, Ha, Minji, Jung, Youn Hea, Kim, Gee-Hyun, Han, Kyung-Do, Kim, Hyun-Seung, Lim, Dong Hui, Na, Kyung-Sun·2020·Scientific Reports
DOI 10.1038/s41598-020-66002-zPMC PMC7272467
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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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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 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.CC BY · PubMed Central
Figure 2 Enrolment flowchart for the study population.
Figure 2 Enrolment flowchart for the study population.CC BY · PubMed Central

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Metadata

Authors
Paik, J.-S., Ha, M., Jung, Y. H., Kim, G.-H., Han, K.-D., Kim, H.-S., Lim, D. H., & Na, K.-S.
Affiliations
  • Catholic University of Korea (KR)
  • Soongsil University (KR)
  • Samsung Medical Center (KR)
Corresponding author
  • Lim, Dong Hui
  • Na, Kyung-Sun
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2020-06-04
Volume
10
Issue
1
Pages
9109-9109
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-020-66002-z
PMC
PMC7272467
OpenAlex
W3033542549
Cited by
54
References
1
Citations by year
2026: 3 · 2025: 10 · 2024: 12 · 2023: 3 · 2022: 11 · 2021: 14 · 2020: 1
FWCI
5.29
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • National Research Foundation (2016R1D1A1B03930886)
  • National Research Foundation of Korea (2019R1F1A1061421, 2016R1A6A1A03010528)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Ophthalmology › Ophthalmology and Visual Impairment Studies
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Keywords
low vision, visual impairment, dementia, Alzheimer's disease, vascular dementia, visual acuity, vision loss, cognitive impairment, Korean population
MeSH terms
Adult, Aged, Aged, 80 and over, Alzheimer Disease, Dementia, Female, Humans, Male, Middle Aged, Risk, Severity of Illness Index, Visual Acuity, Dementia, Vascular, Cohort Studies, Vision, Low, Incidence, Databases, Factual, Republic of Korea

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