{"title":"Association of Visual Impairment With Neuropsychiatric Symptoms of Dementia.","authors":"Melissa Li, Ali G Hamedani","doi":"10.1097/WNO.0000000000002235","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Visual impairment is a risk factor for cognitive impairment and hallucinations in older adults, but associations with other neuropsychiatric symptoms (NPS) of dementia have not been examined.</p><p><strong>Methods: </strong>We analyzed cross-sectional data from the Aging, Demographics, and Memory Study (ADAMS), a nationally representative sample of the US population aged 70+ years. Vision was measured by self-report and using a near card. Dementia was ascertained through cognitive testing with expert consensus, and NPS were screened using the Neuropsychiatric Inventory. We used logistic regression to measure the association between visual impairment and prevalent NPS adjusting for sociodemographic factors and comorbidities. Analyses incorporated sample weights to account for the complex survey design of ADAMS.</p><p><strong>Results: </strong>Of 624 participants with dementia, 332 (53%) had self-reported visual impairment and 193 (31%) had best-corrected acuity of 20/40 or worse. In unadjusted models, self-reported visual impairment was significantly associated with hallucinations (OR 2.88; 95% CI 1.12-7.44), depression (OR 2.79; 95% CI 1.7-4.57), and agitation (OR 1.61; 95% CI 1.05-2.48). Reduced visual acuity was associated with hallucinations (OR 10.13; 95% CI 2.93-34.98), psychosis (OR 6.69, 95% CI 2.53-17.7), and mania (OR 5.92, 95% CI 1.77-19.82). However, these associations did not remain significant after covariate adjustment.</p><p><strong>Conclusions: </strong>Visual impairment was associated with hallucinations, depression, agitation, psychosis, and mania in patients with dementia, but at least some of this relationship is explained by age, comorbidities, and other factors.</p>","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":"131-136"},"PeriodicalIF":2.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830047/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuro-Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/WNO.0000000000002235","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/16 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Visual impairment is a risk factor for cognitive impairment and hallucinations in older adults, but associations with other neuropsychiatric symptoms (NPS) of dementia have not been examined.
Methods: We analyzed cross-sectional data from the Aging, Demographics, and Memory Study (ADAMS), a nationally representative sample of the US population aged 70+ years. Vision was measured by self-report and using a near card. Dementia was ascertained through cognitive testing with expert consensus, and NPS were screened using the Neuropsychiatric Inventory. We used logistic regression to measure the association between visual impairment and prevalent NPS adjusting for sociodemographic factors and comorbidities. Analyses incorporated sample weights to account for the complex survey design of ADAMS.
Results: Of 624 participants with dementia, 332 (53%) had self-reported visual impairment and 193 (31%) had best-corrected acuity of 20/40 or worse. In unadjusted models, self-reported visual impairment was significantly associated with hallucinations (OR 2.88; 95% CI 1.12-7.44), depression (OR 2.79; 95% CI 1.7-4.57), and agitation (OR 1.61; 95% CI 1.05-2.48). Reduced visual acuity was associated with hallucinations (OR 10.13; 95% CI 2.93-34.98), psychosis (OR 6.69, 95% CI 2.53-17.7), and mania (OR 5.92, 95% CI 1.77-19.82). However, these associations did not remain significant after covariate adjustment.
Conclusions: Visual impairment was associated with hallucinations, depression, agitation, psychosis, and mania in patients with dementia, but at least some of this relationship is explained by age, comorbidities, and other factors.
背景:视力障碍是老年人出现认知障碍和幻觉的一个风险因素,但与痴呆症的其他神经精神症状(NPS)之间的关系尚未得到研究:我们分析了老龄化、人口统计和记忆研究(ADAMS)的横断面数据,该研究是对美国 70 岁以上人口的全国代表性抽样调查。视力通过自我报告和使用近视卡进行测量。痴呆症通过认知测试和专家共识来确定,非传染性疾病则使用神经精神疾病量表进行筛查。我们使用逻辑回归法来测量视力障碍与非典型肺炎流行之间的关系,并对社会人口学因素和合并症进行了调整。分析中加入了样本权重,以考虑 ADAMS 复杂的调查设计:在 624 名痴呆症患者中,332 人(53%)自述有视力障碍,193 人(31%)的最佳矫正视力为 20/40 或更差。在未经调整的模型中,自我报告的视力损伤与幻觉(OR 2.88;95% CI 1.12-7.44)、抑郁(OR 2.79;95% CI 1.7-4.57)和躁动(OR 1.61;95% CI 1.05-2.48)显著相关。视敏度降低与幻觉(OR 10.13;95% CI 2.93-34.98)、精神病(OR 6.69,95% CI 2.53-17.7)和躁狂(OR 5.92,95% CI 1.77-19.82)相关。然而,经过协变量调整后,这些关联并不显著:视觉障碍与痴呆症患者的幻觉、抑郁、躁动、精神病和躁狂有关,但这种关系至少有一部分是由年龄、合并症和其他因素造成的。
期刊介绍:
The Journal of Neuro-Ophthalmology (JNO) is the official journal of the North American Neuro-Ophthalmology Society (NANOS). It is a quarterly, peer-reviewed journal that publishes original and commissioned articles related to neuro-ophthalmology.