What is the association between vision impairment and cognitive outcome? PKU1898 VisionImpairment CognitiveOutcome
By Bhavana KunkalikarAug 3 2022Reviewed by Aimee Molineux In a recent study published in the Aging and Mental Health journal, researchers examined the association between cognitive outcomes and vision impairment in elderly populations.
The team performed a meta-analysis and systematic review as per the statement recommendations by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses . Articles published before April 2020 were searched using electronic databases such as Embase, PubMed, PsycINFO, and Web of Science. Two investigators reviewed the relevant articles and independently identified articles eligible for the review.
Related StoriesNewcastle-Ottawa Scale was employed to ascertain the quality of the selected observational studies in the systematic reviews wherein a cut-off value of seven and above indicated higher quality. The risk of bias was also estimated according to the three primary criteria that included selection, comparability, and outcome.
A total of 16 studies focused on the correlation of cognitive outcomes and VI, wherein three relevant studies detected VI with subjective measures. When meta-analysis was performed among longitudinal and cross-sectional studies that examined VI measures, the team noted an enhanced risk of adverse cognitive outcomes. However, the significance of the correlation was greater within the subject measures than in the objective ones.
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Issues and recommendations for the residual approach to quantifying cognitive resilience and reserve - Alzheimer's Research & TherapyBackground Cognitive reserve and resilience are terms used to explain interindividual variability in maintenance of cognitive health in response to adverse factors, such as brain pathology in the context of aging or neurodegenerative disorders. There is substantial interest in identifying tractable substrates of resilience to potentially leverage this phenomenon into intervention strategies. One way of operationalizing cognitive resilience that has gained popularity is the residual method: regressing cognition on an adverse factor and using the residual as a measure of resilience. This method is attractive because it provides a statistical approach that is an intuitive match to the reserve/resilience conceptual framework. However, due to statistical properties of the regression equation, the residual approach has qualities that complicate its interpretation as an index of resilience and make it statistically inappropriate in certain circumstances. Methods and results We describe statistical properties of the regression equation to illustrate why the residual is highly correlated with the cognitive score from which it was derived. Using both simulations and real data, we model common applications of the approach by creating a residual score (global cognition residualized for hippocampal volume) in individuals along the AD spectrum. We demonstrate that in most real-life scenarios, the residual measure of cognitive resilience is highly correlated with cognition, and the degree of this correlation depends on the initial relationship between the adverse factor and cognition. Subsequently, any association between this resilience metric and an external variable may actually be driven by cognition, rather than by an operationalized measure of resilience. We then assess several strategies proposed as potential solutions to this problem, such as including both the residual and original cognitive measure in a model. However, we conclude these solutions may be insufficient, and
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