Does cognitive impairment influence outcomes from cataract surgery? Results from a 1-year follow-up cohort study

Br J Ophthalmol. 2015 Mar;99(3):412-7. doi: 10.1136/bjophthalmol-2014-305657. Epub 2014 Oct 6.

Abstract

Background/aims: To assess the impact of impaired cognition on visual outcomes 1 year following cataract surgery in a cohort of older people.

Methods: Participants aged 75 years or more with bilateral cataract and scheduled for cataract surgery were recruited consecutively. Cognition was assessed using the revised Addenbrooke's cognitive examination (ACE-R). Participants were divided into two groups: normal (ACE-R ≥88) and impaired cognition (ACE-R <88). Visual quality of life (VQOL) and logarithm of minimum angle of resolution visual acuity (VA) were assessed at baseline and 1 year following cataract surgery.

Results: Of 112 participants, 48 (43%) had normal cognition and 64 (57%) had impaired cognition. One year following cataract surgery participants in both groups had significant improvements in VQOL and VA. Visual outcomes at 1 year were significantly better in participants with normal cognition than in those with impaired cognition (95% CIs for difference 0.4-7.0 and 0.02-0.1, for VQOL and VA, respectively). Regression analyses correcting for potential confounders showed a relationship between baseline cognition and VA at 1 year (R(2)=0.30, p=0.001) and a possible relationship between baseline cognition and VQOL at 1 year (R(2)=0.41, p=0.01, this became insignificant after removal of outliers).

Conclusions: Patients with impaired cognition benefit from cataract surgery, but not to the same extent as patients with normal cognition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition / physiology
  • Cognition Disorders / physiopathology*
  • Cognition Disorders / psychology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Intelligence Tests
  • Lens Implantation, Intraocular
  • Male
  • Phacoemulsification*
  • Pseudophakia / physiopathology*
  • Pseudophakia / psychology
  • Quality of Life / psychology
  • Sickness Impact Profile
  • Visual Acuity / physiology*