Abstract
Purpose : The 2024 Lancet Commission on dementia reported worse hearing in mid-life and untreated vision loss in late life, increased risk of dementia by 16% and 40% respectively. This study aims to examine whether vision impairment (VI) and hearing impairment (HI) are associated with cognitive function in a sub-sample of participants from the Australian Eye and Ear Health Survey (AEEHS).
Methods : AEEHS is a nationwide population-based, cross-sectional study of vision and hearing in Australians over 50 years. This sub-study was conducted between June 2022 to May 2023, across the first six sites. Unaided VI was defined as visual acuity worse than 0.3 logMAR (6/12). Habitual VI was letter scored at distance and binocularly at near. Cataracts (cortical, nuclear, posterior-subcapsular) were graded with LOCSIII. Untreated HI (U-HI) was defined as average pure-tone audiometry at 0.5, 1 and 2kHz at ≥23.3 dB. The Hearing Handicap Inventory for the Elderly Score (HHIE-S) was used for self-perceived hearing loss and hearing aid use was self-reported. All variables used were for the better eye or better ear. The associations of treated and untreated VI and HI on Montreal Cognitive Assessment (MoCA) score was modelled using multivariable linear regression, adjusted for age and sex.
Results : A total of 276 participants completed the MoCA. Average score was 24±4 (mean±SD), range 10-30, mean age 69 years, 128 (47%) were male, 55 (20%) had unaided distance and 184 (67%) near VI, 12 (4%) had habitual distance and 39 (14%) near VI, 171 (62%) had ≥ grade 2 nuclear and 15 (5%) cortical cataract, 221 (80%) U-HI, average HHIE-S was 12.3±9.5 and 43 (17%) had a hearing aid. While there were multiple associations with vision and hearing in univariate analysis, cortical cataract (β=-0.61 per LOCSIII unit, p=0.04), habitual near VI (β=-0.93 per line, p<0.0001) and average hearing (β=-0.61 per 10dB, p=0.04) were independently associated with MoCA score (R2=19.6%). Adjusting for hearing aid use did not improve the model.
Conclusions : These findings support the hypothesis sensory impairment is associated with cognitive function. In this dataset few participants had untreated distance VI, while significant numbers had poor habitual near vision, unoperated cataract and HI without hearing aid use, which were associated with cognitive function. Earlier access to cataract surgery and hearing aids provisions may reduce cognitive decline.
Methods : AEEHS is a nationwide population-based, cross-sectional study of vision and hearing in Australians over 50 years. This sub-study was conducted between June 2022 to May 2023, across the first six sites. Unaided VI was defined as visual acuity worse than 0.3 logMAR (6/12). Habitual VI was letter scored at distance and binocularly at near. Cataracts (cortical, nuclear, posterior-subcapsular) were graded with LOCSIII. Untreated HI (U-HI) was defined as average pure-tone audiometry at 0.5, 1 and 2kHz at ≥23.3 dB. The Hearing Handicap Inventory for the Elderly Score (HHIE-S) was used for self-perceived hearing loss and hearing aid use was self-reported. All variables used were for the better eye or better ear. The associations of treated and untreated VI and HI on Montreal Cognitive Assessment (MoCA) score was modelled using multivariable linear regression, adjusted for age and sex.
Results : A total of 276 participants completed the MoCA. Average score was 24±4 (mean±SD), range 10-30, mean age 69 years, 128 (47%) were male, 55 (20%) had unaided distance and 184 (67%) near VI, 12 (4%) had habitual distance and 39 (14%) near VI, 171 (62%) had ≥ grade 2 nuclear and 15 (5%) cortical cataract, 221 (80%) U-HI, average HHIE-S was 12.3±9.5 and 43 (17%) had a hearing aid. While there were multiple associations with vision and hearing in univariate analysis, cortical cataract (β=-0.61 per LOCSIII unit, p=0.04), habitual near VI (β=-0.93 per line, p<0.0001) and average hearing (β=-0.61 per 10dB, p=0.04) were independently associated with MoCA score (R2=19.6%). Adjusting for hearing aid use did not improve the model.
Conclusions : These findings support the hypothesis sensory impairment is associated with cognitive function. In this dataset few participants had untreated distance VI, while significant numbers had poor habitual near vision, unoperated cataract and HI without hearing aid use, which were associated with cognitive function. Earlier access to cataract surgery and hearing aids provisions may reduce cognitive decline.
| Original language | English |
|---|---|
| Article number | 2011 |
| Journal | Investigative ophthalmology & visual science |
| Volume | 66 |
| Issue number | 8 |
| Publication status | Published - Jun 2025 |
| Event | Annual meeting of the Association for Research in Vision and Ophthalmology (ARVO) - Salt Lake City, United States Duration: 4 May 2025 → 8 May 2025 |