title: Higher Cognitive Function in Elderly Individuals with Previous Cataract Surgery: Cross-Sectional Association Independent of Visual Acuity in the HEIJO-KYO Cohort.
abstract: Cataract surgery improves visual acuity and drastically increases the capacity for light reception to the retina. Although previous studies suggested that both light exposure and visual acuity were associated with cognitive function, the relationships between cataract surgery, visual acuity, and cognitive function have not been evaluated in large populations. In this cross-sectional study, we measured cognitive function using the Mini-Mental State Examination and best-corrected visual acuity in pseudophakic (previous cataract surgery) and phakic (no previous cataract surgery) elderly individuals. Of 945 participants (mean age 71.7 years), 166 (17.6%) had pseudophakia and 317 (33.5%) had impaired cognitive function (score ≤26). The pseudophakic group showed significantly better visual acuity than the phakic group (p = 0.003) and lower age-adjusted odds ratio (ORs) for cognitive impairment (OR 0.66; p = 0.038). Consistently, in multivariate logistic regression models, after adjusting for confounding factors, including visual acuity and socioeconomic status, ORs for cognitive impairment were significantly lower in the pseudophakic group than in the phakic group (OR 0.64; 95% confidence interval 0.43-0.96; p = 0.031). This association remained significant in sensitivity analysis, excluding participants with low cognitive score ≤23 (n = 36). In conclusion, in a general elderly population, prevalence of cognitive impairment was significantly lower in pseudophakic individuals independently of visual acuity. The association was also independent of several major causes of cognitive impairment such as aging, gender, obesity, socioeconomic status, hypertension, diabetes, sleep disturbances, depressive symptoms, and physical inactivity.
authors.affiliation: 1 Department of Ophthalmology, Nara Medical University School of Medicine , Nara, Japan .
authors.forename: Kimie
authors.initials: K
authors.lastname: Miyata
authors.affiliation: 2 Department of Community Health and Epidemiology, Nara Medical University School of Medicine , Nara, Japan .
authors.forename: Kenji
authors.initials: K
authors.lastname: Obayashi
authors.affiliation: 2 Department of Community Health and Epidemiology, Nara Medical University School of Medicine , Nara, Japan .
authors.forename: Keigo
authors.initials: K
authors.lastname: Saeki
authors.affiliation: 3 Center for Academic Industrial and Governmental Relations, Nara Medical University School of Medicine , Nara, Japan .
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tone
authors.affiliation: 4 Osaka City University , Graduate School of Medicine, Osaka, Japan .
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: 1 Department of Ophthalmology, Nara Medical University School of Medicine , Nara, Japan .
authors.forename: Tomo
authors.initials: T
authors.lastname: Nishi
authors.affiliation: 5 Mie Prefectural Mental Care Center , Mie, Japan .|6 Department of Psychiatry, Nara Medical University School of Medicine , Nara, Japan .
authors.forename: Masayuki
authors.initials: M
authors.lastname: Morikawa
authors.affiliation: 2 Department of Community Health and Epidemiology, Nara Medical University School of Medicine , Nara, Japan .
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
authors.affiliation: 1 Department of Ophthalmology, Nara Medical University School of Medicine , Nara, Japan .
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ogata
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000523:psychology*; D002387:Cataract Extraction; D016009:Chi-Square Distribution; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D065840:Protective Factors; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014792:Visual Acuity