The Impact of Cataract Surgery on Cognitive Impairment and Depressive Mental Status in Elderly Patients

Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, Japan.
American Journal of Ophthalmology (Impact Factor: 3.87). 07/2008; 146(3):404-9. DOI: 10.1016/j.ajo.2008.05.014
Source: PubMed


To evaluate the influence of cataract surgery on cognitive function and depressive mental status of elderly patients.
Prospective, interventional case series.
The 25-Item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), Mini-Mental State Examination (MMSE), and Beck Depression Inventory (BDI) are the measures designed to assess vision-related quality of life (QOL), cognitive impairment, and depressive mental status, respectively. These tests were performed before and two months after surgery in 102 patients undergoing phacoemulsification and intraocular lens implantation for bilateral cataract.
The change in best-corrected visual acuity by surgery significantly correlated with the change in NEI VFQ-25 score (Pearson correlation, r = -0.310; P = .031). The change in NEI VFQ-25 score by surgery significantly correlated with the change in MMSE score (r = 0.306; P = .035) and the change in BDI score (r = -0.414; P < .001). The change in MMSE score showed significant correlation with the change in BDI score (r = -0.434; P < .001).
Vision-related QOL, cognitive impairment, and depressive mental status are all strongly related with each other. Cataract surgery significantly improved vision-related QOL in elderly patients, and cognitive impairment and depressive mental status also improved in parallel with improvement in vision-related QOL.

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    • "They have been validated by a variety of studies showing they are useful tools in assessing vision-specific quality of life [4] [5] [6] [7] [8]. NEI VFQ-25 is demonstrated to be sensitive to the influence of age related macular degeneration (AMD) [9] [10], glaucomatous field loss [11], cataract [12], Behcet uveitis [13], after penetrating keratoplasty for keratoconus [14], after retinal detachment surgery [15], vitrectomy [16], diabetic retinopathy [17], strabismus [18], multiple sclerosis [19], osteoporotic fractures, and low vision from any cause [20]. The correlations with clinical markers of disease severity provide evidence of clinical validity for the measure. "
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    ABSTRACT: Purpose. The purpose of this study is to evaluate the vision related quality of life in patients with keratoconus by using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25). Methods. Thirty patients presented with keratoconus (keratoconus group) and 30 healthy patients (control group) were included in this study. Twenty patients were using rigid gas permeable and 10 patients were not using contact lenses in keratoconus group. High and low contrast visual acuity and mean K values of the patients were recorded. Each subject completed the 25-item NEI-VFQ-25. Results. All subscales of NEI-VFQ-25 were lower in the keratoconus patients. The difference was more evident in the subscales of general vision, ocular pain, near vision, vision-specific mental health, vision-specific role difficulties, and peripheral vision . Overall composite score was 75.2 +/- 17.2 in the keratoconus group and 93.2 +/- 5.6 in the control group . Contact lens wearers had higher best corrected visual acuity in comparison with noncontact lens wearers . Patients with low visual acuity (logMAR > 0.4) in the better eye had lower distance vision, social functioning, mental health, and role difficulties. Meanwhile, patients with low visual acuity (logMAR > 0.4) in the worse eye had lower general health scores . Conclusions. Vision related quality of life was worse in keratoconus patients. Success in the contact lens usage and maintaining higher visual acuity may improve vision related quality of life.
    Full-text · Article · Apr 2014 · Journal of Ophthalmology
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    • "There was a significant improvement of nearly 15 points in the VRQOL composite score after cataract surgery after controlling for confounding factors. These results are consistent with previous research examining change in NEI VFQ-25 scores after cataract surgery in Japan and the USA [22,23]. "
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    ABSTRACT: To determine the impact of cataract surgery on vision-related quality of life (VRQOL) and examine the association between objective visual measures and change in VRQOL after surgery among bilateral cataract patients in Ho Chi Minh City, Vietnam. A cohort of older patients with bilateral cataract was assessed one week before and one to three months after first eye or both eye cataract surgery. Visual measures including visual acuity, contrast sensitivity and stereopsis were obtained. Vision-related quality of life was assessed using the NEI VFQ-25. Descriptive analyses and a generalized linear estimating equation (GEE) analysis were undertaken to measure change in VRQOL after surgery. Four hundred and thirteen patients were assessed before cataract surgery and 247 completed the follow-up assessment one to three months after first or both eye cataract surgery. Overall, VRQOL significantly improved after cataract surgery (p < 0.001) particularly after both eye surgeries. Binocular contrast sensitivity (p < 0.001) and stereopsis (p < 0.001) were also associated with change in VRQOL after cataract surgery. Visual acuity was not associated with VRQOL. Cataract surgery significantly improved VRQOL among bilateral cataract patients in Vietnam. Contrast sensitivity as well as stereopsis, rather than visual acuity significantly affected VRQOL after cataract surgery.
    Full-text · Article · Feb 2014 · Health and Quality of Life Outcomes
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    • "Since many of the tests used to evaluate cognitive ability in humans are visually-dependent, it is not surprising that poorer scores in these cognitive tasks are associated with visual impairment . Specifically, visual impairment has been associated with poorer scores in memory and cognition on the Mini-Mental State Exam, which has both visual and auditory components (Lin et al., 2004; Gussekloo et al., 2005; Reyes-Ortiz et al., 2005; Ishil et al., 2008) and poorer performance in visually-presented tests of memory, such as the symbol recall, picture recall and The "
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    ABSTRACT: The DBA/2J mouse is a model of pigmentary glaucoma in humans as it shows age-related increases in intraocular pressure (IOP), retinal ganglion cell death and visual impairment. Previously, we showed that visual ability declines from 9 to 12 months of age and visual impairment is correlated with poor learning and memory performance in visuo-spatial tasks but not in tasks that do not depend on visual cues. To test the "sensory impairment" hypothesis of aging, which postulates that sensory impaired individuals are disadvantaged in their performance on psychometric tests as a direct result of difficulties in sensory perception, we treated DBA/2J mice with a conventional glaucoma medication used in humans (Timoptic-XE, 0.00, 0.25, or 0.50%) daily from 9 weeks to 12 months of age to determine whether prevention of vision loss prevented the decline in visuo-spatial learning and memory performance. At all ages tested (3, 6, 9, and 12 months of age), mice treated with Timoptic-XE (0.25 and 0.50%) maintained a high level of performance, while 12 month old control mice (0.00%) exhibited impaired performance in visually-dependent, but not non-visual tasks. These results demonstrate that when sensory function is preserved, cognitive performance is normalized. Thus, as in many aging humans, DBA/2J mice show age-related decrements in performance on visually presented cognitive tests, not because of cognitive impairment but as a direct consequence of poor visual ability. Our results demonstrate that age-related impairment in performance in visuo-spatial tasks in DBA/2J mice can be prevented by the preservation of visual ability.
    Full-text · Article · Sep 2013 · Frontiers in Aging Neuroscience
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