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Association of age-related eye diseases with cognitive frailty in older adults: a population-based study

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Abstract

Background

Age-related eye diseases and cognitive frailty (CF) are both important predictors of adverse health outcomes in older adults, however, little is known about their association.

Aims

To demonstrate the association between age-related eye diseases and cognitive frailty in a population of Iranian older adults.

Methods

In this cross-sectional, population-based study, we included 1136 individuals (female n = 514) aged 60 years and older (mean 68.8 ± 6.7 years) who participated in the second cycle of the Amirkola Health and Aging Project (AHAP) between 2016 and 2017. Cognitive function and frailty were evaluated based on Mini-Mental State Examination (MMSE) and the FRAIL scale respectively. Cognitive frailty was defined as coexistence of cognitive impairment (CI) and physical frailty (PF), excluding confirmed cases of dementia such as Alzheimer’s disease. Cataract, diabetic retinopathy (DR), age-related macular degeneration (AMD), elevated intraocular pressure (IOP ≥ 21 mmHg) and glaucoma suspects (vertical cup to disc ratio (VCDR) ≥ 0.6) were diagnosed based on standardized grading protocols. Associations between eye diseases and cognitive frailty were evaluated through binary logistic regression analysis.

Results

Overall, CI, PF and CF were observed in 257 (22.6%), 319 (28.1%) and 114 (10.0%) participants respectively. After adjusting for confounders and ophthalmic conditions, individuals with cataract were more likely to have CF (OR 1.66; p-value 0.043), while DR, AMD, elevated IOP and glaucoma suspects (OR 1.32, 1.62, 1.42, 1.36, respectively) were not significantly associated with CF. Furthermore, cataract was significantly associated with CI (OR 1.50; p-value 0.022), but not with frailty (OR 1.18; p-value 0.313).

Conclusion

Older adults with cataract were more likely to have cognitive frailty and cognitive impairment. This association demonstrates the implications of age-related eye diseases beyond ophthalmology and substantiates the need for further research involving cognitive frailty in the context of eye diseases and visual impairment.

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Data availability

The datasets used during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

    Mohammad Javad Ghanbarnia, Seyed Reza Hosseini, Reza Ghadimi & Ali Bijani

  2. Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran

    Mohammad Javad Ghanbarnia, Mehrnoosh Ghasemi, Gholam Abbas Roustaei, Ebrahim Mekaniki & Seyed Ahmad Rasoulinejad

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  1. Mohammad Javad Ghanbarnia
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  2. Seyed Reza Hosseini
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  3. Mehrnoosh Ghasemi
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Contributions

MJG was involved in conception and design of the study, data analysis and interpretation, writing and reviewing the manuscript. SRH was involved in design, data analysis and interpretation and revising the manuscript. SAR, MG, GAR and EM were involved in ophthalmological clinical examinations, data acquisition and interpretation. RG and AB were involved in design, data acquisition. All authors take responsibility for the content of the manuscript. All authors revised and reviewed the manuscript and approved the final version to be published.

Corresponding author

Correspondence to Seyed Ahmad Rasoulinejad.

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All authors declare they have no conflict of interest to disclose.

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Study protocol adhered to the tenets of declaration of Helsinki and it was approved by the ethics committee of Babol University of Medical Sciences.

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Ghanbarnia, M.J., Hosseini, S.R., Ghasemi, M. et al. Association of age-related eye diseases with cognitive frailty in older adults: a population-based study. Aging Clin Exp Res 35, 1731–1740 (2023). https://doi.org/10.1007/s40520-023-02458-z

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