The association between structure-function relationships and cognitive impairment in elderly glaucoma patients.

Area of Science:

• Ophthalmology
• Neuroscience
• Geriatrics

Background:

• Accurate visual field (VF) measurement is crucial for glaucoma assessment.
• Cognitive impairment (CI), including mild cognitive impairment (MCI) and dementia, is prevalent in elderly populations.
• CI can compromise the reliability of standard VF testing in glaucoma patients.

Purpose of the Study:

• To investigate the association between cognitive impairment and structure-function relationships in elderly glaucoma patients.
• To determine if cognitive status influences the accuracy of VF measurements derived from optical coherence tomography (OCT) data.

Main Methods:

• Included 94 eyes from 51 glaucoma patients (age ≥75 years) without dementia diagnoses.
• Assessed cognitive function using the Mini Mental State Examination (MMSE).
• Predicted Mean Deviation (MD) from OCT measurements using leave-one-out cross-validation and analyzed prediction errors against MMSE scores, age, and VF test parameters (FL, FP, FN) via linear mixed models.

Main Results:

• A significant association was found between decreased structure-function relationships and lower MMSE scores.
• The squared prediction error of MD increased as MMSE scores decreased.
• Age, fixation loss (FL), false positive (FP), and false negative (FN) percentages did not show a significant relationship with prediction error.

Conclusions:

• Cognitive impairment in elderly glaucoma patients is common and impacts the reliability of VF testing.
• Decreased structure-function relationships, indicated by increased prediction error, are linked to lower cognitive function.
• Clinicians must carefully interpret VF results in elderly glaucoma patients with CI due to potential over- or underestimation.