Evidence map›Paper›PMID 34992100›Full record

SynthesisBMJ open2022

Vision impairment and cognitive decline among older adults: a systematic review.

Niranjani Nagarajan, Lama Assi, V Varadaraj, Mina Motaghi, Yi Sun, Elizabeth Couser, Joshua R Ehrlich, Heather Whitson, Bonnielin K Swenor

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 4 pooled it
16.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 4 syntheses or guidelines pooled it, 115 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. [PAPPS update on older people 2024].Atencion primaria · 2024
    Guideline
  4. Pooled it
  5. Observational
  6. Article
  7. Article
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  9. Article
  10. Article
  11. Review
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  13. Article
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  16. Article
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  18. Investigating stroke-related vision impairments and time to incident dementia diagnosis.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
    Article
  19. Review
  20. Article

8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Niranjani NagarajanWilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0003-2443-7058
Lama AssiWilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0001-5855-3896
V VaradarajWilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Mina MotaghiJohns Hopkins School of Public Health, Baltimore, Maryland, USA.
Yi SunJohns Hopkins School of Public Health, Baltimore, Maryland, USA.
Elizabeth CouserJohns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Joshua R EhrlichOphthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-0607-3564
Heather WhitsonDepartment of Medicine, Geriatrics, Duke University, Durham, North Carolina, USA.
Bonnielin K SwenorWilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA bswenor@jhu.edu.
Johns Hopkins University · USDuke University · USUniversity of Michigan · US

Funding

The National Health and Trends StudyU01AG032947 · NIA · JOHNS HOPKINS UNIVERSITY · PI VICKI A. FREEDMAN, JENNIFER ANN SCHRACK · 2008 to 2026
$169.4M
Research Education ComponentP30AG066507 · NIA · JOHNS HOPKINS UNIVERSITY · PI MARILYN S. ALBERT · 2020 to 2026
$29.3M
Research Training in Age-Related Cognitive DisordersT32AG027668 · NIA · JOHNS HOPKINS UNIVERSITY · PI MARILYN S. ALBERT · 2007 to 2026
$6.3M
Addressing Low Vision due to Severe Peripheral Field Loss: Development and Validation of a Patient-Centered Outcome MeasureK23EY027848 · NEI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI EHRLICH, JOSHUA ROBERT · 2017 to 2021
$1.2M
Vision Loss and Cognition: Testing the sensory consequence hypothesisK01AG052640 · NIA · JOHNS HOPKINS UNIVERSITY · PI SWENOR, BONNIELIN · 2017 to 2021
$834k
NEI NIH HHS K23 EY027848NIA NIH HHS K01 AG052640NIA NIH HHS P30 AG066507NIA NIH HHS T32 AG027668NIA NIH HHS U01 AG032947
6 · The paper itself

Abstract

objectivesThere has been increasing epidemiological research examining the association between vision impairment (VI) and cognitive impairment and how poor vision may be a modifiable risk factor for cognitive decline. The objective of this systematic review is to synthesise the published literature on the association of VI with cognitive decline, cognitive impairment or dementia, to aid the development of interventions and guide public policies pertaining to the relationship between vision and cognition.

methodsA literature search was performed with Embase, Medline and Cochrane library databases from inception to March 2020, and included abstracts and articles published in peer-reviewed journals in English. Our inclusion criteria included publications that contained subjective/objective measures of vision and cognition, or a diagnosis of VI, cognitive impairment or dementia. Longitudinal or cross-sectional studies with ≥100 participants aged >50 years were included. The search identified 11 805 articles whose abstracts underwent screening by three teams of study authors. Data abstraction and quality assessment using the Effective Public Health Practice Project Quality Assessment Tool were performed by one author (NN). 10% of the articles underwent abstraction and appraisal by a second author (LA/VV), results were compared between both and were in agreement.

results110 full-text articles were selected for data extraction, of which 53 were cross-sectional, 43 longitudinal and 14 were case-control studies. The mean age of participants was 73.0 years (range 50-93.1). Ninety-one (83%) of these studies reported that VI was associated with cognitive impairment.

conclusionOur systematic review indicates that a majority of studies examining the vision-cognition relationship report that VI is associated with more cognitive decline, cognitive impairment or dementia among older adults. This synthesis supports the need for additional research to understand the mechanisms underlying the association between VI and cognitive impairment and to test interventions that mitigate the cognitive consequences of VI.

Indexed as

Cognitive DysfunctionDementiaAgedAged, 80 and overCognitionConcept FormationHumansMiddle AgedRisk Factorsdelirium & cognitive disordersepidemiologygeriatric medicineophthalmology

Identifiers

PMID34992100
PMCPMC8739068
OpenAlexW4206150383

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.