Age-related eye disease and cognitive function.

PURPOSE: To determine whether people with age-related eye disease have lower cognitive scores than people with healthy vision. METHODS: A hospital-based cross-sectional study was performed in which 420 people aged 65 and older from the ophthalmology clinics at Maisonneuve-Rosemont Hospital (Montreal, Canada) were recruited who had age-related macular degeneration (AMD), Fuch's corneal dystrophy, or glaucoma. Patients with AMD and Fuchs had to have visual acuity in the better eye of worse than 20/40 while patients with glaucoma had to have visual field in their worse eye of at least -4 dB. Controls, recruited from the same clinics, did not have significant vision loss. Cognitive status was measured using the Mini-Mental State Exam Blind Version (range, 0-22) which excludes eight items that rely on vision. Linear regression with bootstrapped standard errors was used to adjust for demographic and medical factors. RESULTS: People with AMD, Fuch's corneal dystrophy, and glaucoma had lower cognitive scores, on average, than controls (P < 0.05). These relationships remained statistically significant after adjusting for factors such as age, sex, race, education, living alone, systemic comorbidities, and lens opacity. CONCLUSIONS: People with vision loss due to three different age-related eye diseases had lower cognitive scores. Reasons for this should be explored using longitudinal studies and a full battery of cognitive tests that do not rely on vision.

Visual difficulty and employment status in the world.

PURPOSE: Using a world-wide, population-based dataset, we sought to examine the relationship between visual difficulty and employment status. METHODS: The World Health Survey was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design. Far vision was assessed by asking about the level of difficulty in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters). Responses included none, mild, moderate, severe, or extreme/unable. Participants were asked about their current job, and if they were not working, the reason why (unable to find job, ill health, homemaker, studies, unpaid work, other). The occupation in the last 12 months was obtained. Multinomial regression was used accounting for the complex survey design. RESULTS: Of those who wanted to work, 79% of those with severe visual difficulty and 64% of those with extreme visual difficulty were actually working. People who had moderate, severe, or extreme visual difficulty had a higher odds of not working due to an inability to find a job and of not working due to ill health after adjusting for demographic and health factors (P<0.05). CONCLUSIONS: As the major causes of visual impairment in the world are uncorrected refractive error and cataract, countries are losing a great deal of labor productivity by failing to provide for the vision health needs of their citizens and failing to help them integrate into the workforce.