Cognitive Performance Concomitant With Vision Acuity Predicts 13-Year Risk for Mortality.

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• Cognitive performance and visual acuity are crucial for daily functioning and health outcomes in older adults.
• Previous research suggests individual impacts of cognitive impairment and visual impairment on mortality.
• The combined effect of these sensory and cognitive deficits on long-term mortality remains less understood.

Purpose of the Study:

• To investigate the synergistic impact of cognitive performance and visual acuity on all-cause and cause-specific mortality.
• To quantify the mortality risk associated with the co-occurrence of cognitive impairment and visual impairment in a US elderly population.

Main Methods:

• Utilized data from the National Health and Nutrition Examination Survey (NHANES) linked with the National Death Index (NDI) for mortality follow-up.
• Defined cognitive impairment using the Digit Symbol Substitution Test (DSST) and visual impairment (VI) based on presenting visual acuity.
• Employed Cox proportional hazards models to estimate adjusted risks of mortality over a 13-year follow-up period.

Main Results:

• In participants aged 60+, cognitive impairment and VI were independently associated with increased mortality.
• The co-presence of both cognitive impairment and VI predicted a nearly threefold increased risk of all-cause mortality (HR, 2.74).
• Combined impairments showed a particularly high risk for non-cardiovascular disease/non-cancer mortality, with an almost fourfold higher risk (HR, 3.72).

Conclusions:

• Poorer cognitive performance in individuals aged 60 and over is linked to elevated long-term mortality risk.
• Visual impairment exacerbates mortality risk in cognitively impaired older adults, highlighting a critical vulnerability.
• Findings underscore the importance of early preventive interventions targeting both cognitive and visual health in the elderly.