Cognitive Trajectory Before and After Cataract Surgery: A Population-Based Approach

Area of Science:

• Ophthalmology
• Gerontology
• Cognitive Science

Background:

• Cataract surgery is the most frequent surgical procedure for older adults in the US.
• Cataracts are linked to diminished cognitive function and increased dementia risk.
• The impact of cataract surgery on cognitive function in older adults remains unclear.

Purpose of the Study:

• To investigate the association between cataract surgery and long-term cognitive changes in older US adults.
• To determine if cataract surgery influences cognitive trajectories in the aging population.

Main Methods:

• Analysis of community-dwelling participants from the Health and Retirement Study (2000-2018) linked with Medicare data.
• Propensity score matching of 4384 cataract surgery patients with 4384 controls based on demographics, health status, and cognitive function.
• Linear mixed-effects models used to assess cognitive changes from 5 years pre-surgery to 5 years post-surgery, with difference-in-differences as the primary measure.

Main Results:

• No significant difference in cognitive decline was observed between the cataract surgery group and the control group in the first postoperative year.
• Cataract surgery participants declined slightly faster (0.002 units) than controls, equivalent to 8 days of additional cognitive aging, though this was not statistically significant.
• Subgroup analyses revealed no cognitive differences based on pre-procedural cognitive status or vision impairment levels.

Conclusions:

• Under typical US practice, cataract surgery in older patients is not significantly associated with cognitive improvement or decline within the year after surgery.
• The findings suggest that cataract surgery, while crucial for vision restoration, may not directly influence cognitive aging in the short term.