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Cognitive profile of elders in an ophthalmic ambulatory setting
  1. Mireya Diaz1,2,
  2. Marie Norell3,
  3. Julie Belkin3,
  4. Annapurna Singh3,
  5. William Reinhart3,
  6. Jonathan Lass1,3
  1. 1Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA
  2. 2Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
  3. 3Department of Ophthalmology and Visual Sciences, Case Western Reserve University and University Hospital Eye Institute, Cleveland, Ohio, USA
  1. Correspondence to Dr Mireya Diaz, Vattikuti Urology Institute, Henry Ford Hospital, 2799 West, Grand Boulevard, Detroit, MI 48202, USA; minsua1{at}


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 MMSEblind (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.

  • Visual acuity
  • Mini-mental State Examination
  • cognitive ageing
  • factor structure
  • Vision
  • epidemiology

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  • Funding Financial support for this work was provided by NIH grants R21 EY015145 and P30 EY11373, Research to Prevent Blindness and the Ohio Lions Eye Research Foundation to JL.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Institutional Review Board of University Hospitals Case Medical Center in Cleveland, Ohio.

  • Provenance and peer review Not commissioned; externally peer reviewed.