Association of Vision Impairment With Cognitive Decline Across Multiple Domains in Older Adults

  • The objective of the study is to examine the association between vision and cognitive across multiple cognitive domains using multiple measures of vision.

  • This longitudinal cohort study used data from the Baltimore Longitudinal Study of Aging for 2003 to 2019. 

  • Participants in the current study were aged 60 to 94 years with vision and cognitive measures. Data analysis was performed from May 2020 to May 2021.

  • Cognitive function was measured across multiple domains, including language, memory, attention, executive function, and visuospatial ability. 

  • Cognitive domain scores were calculated as the mean of standardized cognitive test scores within each domain. 

  • Visual function was assessed using measures of visual acuity, contrast sensitivity, and stereo acuity at baseline.

  • Analyses included 1202 participants (610 women [50.8%]; 853 White participants [71.0%]) with a mean (SD) age of 71.1 (8.6) years who were followed up for a mean (SD) of 6.9 (4.7) years.

  • These findings suggest that the association between vision and cognition differs between visual acuity, contrast sensitivity, and stereo acuity and that patterns of cognitive decline may differ by type of vision impairment, with impaired contrast sensitivity being associated with declines across more cognitive domains than other measures of visual functioning.

Publication date

September 10, 2021


JAMA Network Open

Sponsor Institution

National Institutes of Health through the Intramural Research Program of the National Institute on Aging


Varshini Varadaraj, MD, MPH; Beatriz Munoz, MS; Jennifer A. Deal, PhD; Yang An, MS; Marilyn S. Albert, PhD; Susan M. Resnick, PhD; Luigi Ferrucci, MD, PhD; Bonnielin K. Swenor, PhD, MPH
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