Vision is key to aging gracefully, new study says

Aging isn't easy on the eyes or the memory, but doctors of optometry can positively impact a patient's outlook. Two new studies confirm eye health and vision care play an important role in maintaining quality of life.

The first study was published September 2018 in JAMA Ophthalmology. Researchers used data from the SEE study, conducted over four rounds between September 1993 and July 2003, which consisted of about 2,500 participants ranging in age from 65 to 84 and residing in the Salisbury, Maryland, area.

Visual acuity was assessed using Early Treatment Diabetic Retinopathy Study charts and cognition using the Mini-Mental State Examination. Researchers at the University of Miami Miller School of Medicine, Johns Hopkins University School of Medicine and Purdue University Department of Human Development and Family Studies confirmed not only that visual acuity and cognitive impairment were linked, but also reported that vision is "likely the driving force" in the changes, not the reverse.

"The number of U.S. residents older than 65 years is projected to more than double in the next 40 years, increasing from 40.2 million in 2010 to 88.5 million in 2050," the researchers write. "Maintaining good cognitive ability is crucial for older adults' day-to-day functions and an essential component in healthy aging. Understanding the cognitive changes that accompany aging and finding ways to slow down the pace of cognitive decline is critical for maintaining well-being in late life.

"The longitudinal association between vision and cognitive functioning suggests maintaining good vision may be an important interventional strategy for mitigating age-related cognitive changes," they add. "Our findings reinforce the importance of the primary prevention of visual impairment that could be achieved through the prevention of disabling ocular conditions and treatment of correctable visual impairment."

In the second study published October 2018 in Neuropsychologia, Canadian researchers looked at visual sampling behavior and the neural activity within the hippocampus, a region of the brain essential to long-term memory and learning. For the study, they compared that activity between younger adults (mean age 22.95 years) and older adults (mean age 71.43 years) who both engaged in face-processing tasks for the study.

In this study, researchers affiliated with the University of Toronto tracked gaze fixations induced from visual stimuli novel and repeated, including 120 images of unfamiliar faces. The number of gaze fixations indicate whether the faces would be remembered in the future, they say.

"In conclusion, aging is associated with a reduction in the functional relationship between visual exploration and neural activity," the researchers say. "This suggests that the visual memory deficits often observed in aging may be due to declining binding processes along the visual processing hierarchy, as well as the hippocampus, that would ordinarily serve to accumulate and integrate visual information across space and time to form a coherent and lasting memory representation."

Role of optometry

Rebecca Wartman, O.D., practices in North Carolina, where she sees patients in nursing homes exclusively. Dr. Wartman also served on the committee that revised the AOA's Optometric Care of Nursing Home Residents manual in 2014, a resource for doctors of optometry caring for nursing home patients and others seeking nursing home care access.

Healthy vision matters especially as America ages, says Dr. Wartman, noting that more should be done to educate health professionals, older adults, their family members, nursing home operators and policymakers about the essentialness of regular, comprehensive eye examinations in maintaining eye health and how ocular health can greatly improve quality of life for older patients.

"The longitudinal study demonstrates what we have long known-poor vision can lead to cognitive decline," Dr. Wartman says. "Any sensory loss can lead to isolation, a lack of stimulation and/or the ability to take part in many activities of daily life.

"As a profession, we need to take these findings seriously and ensure, to the best of our ability, that we attend to all the visual needs of seniors," she says. "This becomes more important as the population ages. We need to be even more aggressive in our public health messaging to ensure that the public understands the importance of preventative care and measures to protect vision throughout life."