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Vision impairments reduce cognitive test performance

Nature Aging volume 1, pages 975–976 (2021)Cite this article

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To the Editor — Cognitive tests are critical for the reliable assessment of cognitive functioning in an aging population. However, even validated psychometric tests are subject to a variety of extraneous factors (for example, culture and language) that may affect performance. Regarding aging, one factor that stands out is reduced visual function. Indeed, performance on cognitive tests has been found to be negatively affected by vision impairment (for example, age-related macular degeneration or cataracts)1,2,3. When vision impairment is neglected during assessments, poor test scores may be falsely attributed to lower cognitive ability2. This oversight can have substantial ramifications for research on cognitive functioning and the accurate diagnosis of cognitive impairment.

In research, visual assessments by trained optometrists and ophthalmologists are often not feasible because of time and budget constraints. Yet it is estimated that 206 million people over the age of 50 have a moderate to severe vision impairment, and this number is expected to double by 2050 (ref. 4). To further compound the issue, previous research estimates that between 20% and 50% of older individuals will have an undetected (and thus undeclared) visual impairment5. Moreover, elderly patients with age-related macular degeneration, cataracts, glaucoma and diabetic retinopathy have been found to be inaccurate when reporting on their own eye condition6.

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Fig. 1: Performance on visual and non-visual cognitive tasks can differ between people with and without a visual impairment, even if they have equivalent cognitive abilities.

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Authors and Affiliations

  1. Cognitive Ageing & Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia

    Anne Macnamara, Scott Coussens & Tobias Loetscher

  2. Department of Psychology, Faculty of Society & Design, Bond University, Gold Coast, Queensland, Australia

    Victor R. Schinazi

  3. Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore

    Victor R. Schinazi

  4. Department of Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia

    Celia Chen

Authors
  1. Anne Macnamara
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  2. Victor R. Schinazi
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  3. Celia Chen
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  4. Scott Coussens
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  5. Tobias Loetscher
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Contributions

A.M., V.R.S. and T.L. conceptualized the correspondence. All authors contributed to and approved the final version the correspondence.

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Correspondence to Tobias Loetscher.

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The authors declare no competing interests.

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Macnamara, A., Schinazi, V.R., Chen, C. et al. Vision impairments reduce cognitive test performance. Nat Aging 1, 975–976 (2021). https://doi.org/10.1038/s43587-021-00135-2

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