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Relationship Between Visual Acuity and Cognitive Functions in Older Adults With Visual Impairment: The Mediating Role
Nurcan Düzgün1, Sibel Arguvanlı Çoban2, Ali Ender Kulak3
1Faculty of Nursing, Department of Mental Health and Disease Nursing, Gazi University, Ankara, Türkiye.
Background:
There is a complex and interacting relationship between visual acuity, cognitive dysfunction, and frailty. It is suggested that frailty may mediate the relationship between visual acuity and cognitive impairment in older adults.
Objectives:
This study aimed to examine the mediating role of frailty in the relationship between visual acuity and cognitive function in older adults with visual impairment.
Methods:
This cross-sectional correlational study was conducted with 116 participants with visual impairment at an ophthalmology clinic in Turkey between January and February 2025. Data were collected using an information form, the Standardized Mini-Mental Test, and the Edmonton Frailty Scale. Visual acuity was expressed as a logMAR score, ranging from 1.00 to -0.30.
Results:
The mean age of the participants was 70.92 ± 5.92. The logMAR score positively and significantly associated with frailty levels (p < 0.001). Frailty was found to have a significant negative effect on cognitive function (p < 0.001). In addition, a significant negative relationship was identified between cognitive function and the logMAR score (p < 0.01). Both the total and direct effects of the logMAR score on cognitive function were significant (p < 0.001). The indirect effect, tested using the bootstrap method, was also significant (Coeff = -5.304, BootSE = 1.079, 95% CI [-7.652, -3.462]).
Conclusions:
These results suggest that the deterioration of visual acuity strongly impacts cognitive function and that frailty may mediate this relationship. Protecting visual health and preventing frailty in older adults may play a critical role in reducing the risk of cognitive impairment. Regular eye examinations, early intervention for vision disorders, and frailty prevention strategies can contribute to maintaining cognitive health.
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