title: The association between diagnosed glaucoma and cataract and cognitive performance in very old people: cross-sectional findings from the newcastle 85+ study.
abstract: OBJECTIVE
  Common age-related eye diseases including glaucoma, cataract and age-related macular degeneration (AMD) have been proposed to be associated with dementia. Few studies have examined the relationship between cognition and cataract or glaucoma. We explored the association between cognition and cataract and glaucoma diagnoses in community-dwelling 85-year-olds.
  
  
  METHODS
  Cross-sectional analysis of data from the Newcastle 85+ Study. Diagnoses of eye disease were extracted from family practice records. Cognitive performance was assessed by the standardized mini-mental state examination (sMMSE) and the sMMSE-blind (MMblind). Relationships between glaucoma diagnosis or cataract diagnosis and lower cognition were examined using ordinal logistic regression.
  
  
  RESULTS
  Complete data were available for 839 participants. Of these, 36.0% (302/839) had recorded previous cataract surgery, 11.2% (94/839) untreated cataract and 7.9% (66/839) diagnosed glaucoma. Glaucoma diagnosis was associated with lower sMMSE results (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.05-2.95); but not lower MMblind (OR 1.17, 95% CI 0.65-2.12). When compared to no cataract, cataract diagnosis (treated and untreated combined) was associated with higher sMMSE (OR 0.55, 95% CI 0.38-0.79) and MMblind (OR 0.51, 95% CI 0.34-0.76). Previously treated cataract was associated with higher sMMSE (OR 0.72, 95% CI 0.59-0.88) and MMblind (OR 0.68, 95% CI 0.55-0.85). Untreated cataract was not significantly associated with sMMSE (OR 0.65, 95% CI 0.36-1.19) or MMblind (OR 0.73, 95% CI 0.39-1.36).
  
  
  CONCLUSIONS
  This large epidemiological study of 85-year-olds found that lower sMMSE but not MMblind was associated with glaucoma diagnosis, suggesting the association may be driven by poor vision. Cataract diagnosis was associated with higher sMMSE and MMblind. Reasons for this observation are unclear but may relate to enhanced help-seeking behavior in people with diagnosed cataract.
authors.affiliation: Institute for Ageing and Health, Newcastle University, UK. joanna.jefferis@ncl.ac.uk
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Jefferis
authors.forename: John-Paul
authors.initials: JP
authors.lastname: Taylor
authors.forename: Joanna
authors.initials: J
authors.lastname: Collerton
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.forename: Andrew
authors.initials: A
authors.lastname: Kingston
authors.forename: Karen
authors.initials: K
authors.lastname: Davies
authors.forename: Tom
authors.initials: T
authors.lastname: Kirkwood
authors.forename: Michael P
authors.initials: MP
authors.lastname: Clarke
mesh_terms: D000369:Aged, 80 and over; D002386:Cataract / Q000175:diagnosis* / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007361:Intelligence Tests; D008297:Male