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

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

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.

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).

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