Aims To assess the potential association between vision and cognition in an ambulatory older population.

Methods A sample of 84 adults aged 65 and older seeking non-emergent ophthalmic care. Participants were interviewed with the Mini-Mental State Examination (MMSE) during their regular scheduled visit.

Results The average individual was a 78-year-old female, with at least a high school diploma and mildly affected vision (logMAR 0.27). Vision and cognition scores were unrelated (Pearson=−0.09, p=0.41). An MMSE<24 (out of 30) was found in 19% of individuals. A score of 16 in the MMSE_blind (out of 22) identified 14 (88%) of them. Memory was the most frequently affected component (13 patients, 81%), and recall the most frequently involved item (nine patients, 56%). More individuals (16–26%) with moderate to severe vision impairment (logMAR 0.6 to 1.3) tended to have psychomotor and concentration deficiencies and fewer (14%) memory problems compared with those with normal vision or mild impairment (logMAR −0.3 to 0.5). Language was uniformly affected across levels of vision impairment.

Conclusions An absent relationship between cognition and vision based on overall scores of standard instruments does not preclude the existence of such association as characterised by more comprehensive measures, and thus greater vision impairment may confer some cognitive ageing in specific abilities.