From JAMA Community, December 2021:

Affiliation Between Cataract Extraction and Improvement of Dementia

Query  Is cataract extraction related to lowered threat of growing dementia?

Findings  On this cohort examine assessing 3038 adults 65 years of age or older with cataract enrolled within the Grownup Modifications in Thought examine, contributors who underwent cataract extraction had decrease threat of growing dementia than those that didn’t have cataract surgical procedure after controlling for quite a few further dangers. As compared, threat of dementia didn’t differ between contributors who did or didn’t bear glaucoma surgical procedure, which doesn’t restore imaginative and prescient.

That means  This examine means that cataract extraction is related to decrease threat [~30% less] of growing dementia amongst older adults.

Significance  Visible perform is vital for older adults. Interventions to protect imaginative and prescient, corresponding to cataract extraction, could modify dementia threat.

---

Particulars within the summary:

Goal  To find out whether or not cataract extraction is related to lowered threat of dementia amongst older adults.

Design, Setting, and Individuals  This potential, longitudinal cohort examine analyzed information from the Grownup Modifications in Thought examine, an ongoing, population-based cohort of randomly chosen, cognitively regular members of Kaiser Permanente Washington. Examine contributors had been 65 years of age or older and dementia free at enrollment and had been adopted up biennially till incident dementia (all-cause, Alzheimer illness, or Alzheimer illness and associated dementia). Solely contributors who had a analysis of cataract or glaucoma earlier than enrollment or throughout follow-up had been included within the analyses (ie, a complete of 3038 contributors). Knowledge used within the analyses had been collected from 1994 via September 30, 2018, and all information had been analyzed from April 6, 2019, to September 15, 2021.

Exposures  The first publicity of curiosity was cataract extraction. Knowledge on analysis of cataract or glaucoma and publicity to surgical procedure had been extracted from digital medical data. Intensive lists of dementia-related threat elements and health-related variables had been obtained from examine go to information and digital medical data.

Principal Outcomes and Measures  The first final result was dementia as outlined by Diagnostic and Statistical Handbook of Psychological Problems (Fourth Version) standards. Multivariate Cox proportional hazards regression analyses had been performed with the first final result. To deal with potential wholesome affected person bias, weighted marginal structural fashions incorporating the likelihood of surgical procedure had been used and the affiliation of dementia with glaucoma surgical procedure, which doesn’t restore imaginative and prescient, was evaluated.

Outcomes  In whole, 3038 contributors had been included (imply [SD] age at first cataract analysis, 74.four (6.2) years; 1800 girls (59%) and 1238 males (41%); and 2752 (91%) self-reported White race). Based mostly on 23 554 person-years of follow-up, cataract extraction was related to considerably lowered threat (hazard ratio, Zero.71; 95% CI, Zero.62-Zero.83; P < .001) of dementia in contrast with contributors with out surgical procedure after controlling for years of schooling, self-reported White race, and smoking historical past and stratifying by apolipoprotein E genotype, intercourse, and age group at cataract analysis. Related outcomes had been obtained in marginal structural fashions after adjusting for an in depth record of potential confounders. Glaucoma surgical procedure didn’t have a major affiliation with dementia threat (hazard ratio, 1.08; 95% CI, Zero.75-1.56; P = .68). Related outcomes had been discovered with the event of Alzheimer illness dementia.

Conclusions and Relevance  This cohort examine discovered that cataract extraction was considerably related to decrease threat of dementia improvement. If validated in future research, cataract surgical procedure could have scientific relevance in older adults susceptible to growing dementia.

---

What else reduces threat of dementia? The Mediterranean Eating regimen!

Steve Parker, M.D.