Key takeaways:
- Cataract surgical procedure had a protecting impact in opposition to general dementia and Alzheimer’s however not vascular dementia.
- There was no safety in sufferers with anxiousness or despair.
Cataract surgical procedure could scale back the danger of growing dementia, notably Alzheimer’s illness, however not in sufferers with anxiousness or despair, based on knowledge printed in British Journal of Ophthalmology.
“Cataract, a extremely prevalent ophthalmic situation, not solely compromises imaginative and prescient however has additionally been linked to cognitive decline and [common mental disorders such as anxiety or depression],” Shih-Kai Kao, of Shin Kong Wu Ho-Su Memorial Hospital, Taiwan, and colleagues wrote. “Encouragingly, prior analysis has urged that cataract surgical procedure could scale back the danger of dementia in affected sufferers.
“Nonetheless, most present research have targeted on the overall inhabitants, with little consideration paid as to if people with concurrent [common mental disorders] and cataracts can obtain related protecting results in opposition to dementia after surgical procedure. Moreover, the protecting results of cataract surgical procedure on completely different dementia subtypes stay underexplored.”
Kao and colleagues used the TriNetX database to conduct a retrospective cohort examine of 75,757 sufferers aged 65 years or older recognized with cataract between 2012 and 2021. The sufferers had been grouped primarily based on whether or not they had cataract surgical procedure inside 1 12 months of analysis, and the incidence of dementia inside 5 years was in contrast between the 2 teams. The chance for dementia in sufferers with anxiousness or despair who underwent cataract surgical procedure was additionally analyzed.
Cataract surgical procedure had a major protecting impact in opposition to dementia (P < .001). Surgical procedure additionally considerably diminished the danger of growing Alzheimer’s illness (P < .001), however it didn’t have a major impact on vascular dementia danger.
In sufferers who had cataract surgical procedure, solely these with no frequent psychological issues had a diminished danger for dementia (P < .001). The variations in danger weren’t vital for these categorised as having despair, anxiousness or anxious despair.
“The discovering of this examine implies that cataract surgical procedure could confer a protecting impact in opposition to dementia in sufferers with out [common mental disorders]; nonetheless, this impact could also be diminished or absent in sufferers who current with [a common mental disorder] or comorbid anxiousness and despair,” Kao and colleagues wrote. “We hypothesize that the restricted advantages in these circumstances could also be attributed to the prevailing substantial cognitive burden skilled by sufferers, making the potential dementia-preventing impact of cataract surgical procedure inadequate to considerably scale back the danger of dementia in sufferers with [common mental disorders] after surgical procedure.
“From a scientific follow perspective, ophthalmologists may pay nearer consideration to the cognitive perform of sufferers with concurrent [common mental disorders] and cataracts, offering applicable referral companies when mandatory.”
Perspective
This examine affords vital insights into the connection between cataract surgical procedure, psychological well being and dementia danger. Whereas earlier analysis has linked cataract surgical procedure to a diminished danger for dementia, this investigation particularly highlights that the protecting impact is critical for general dementia and notably for Alzheimer’s illness however not for vascular dementia. Crucially, the examine reveals that this protecting profit is diminished or absent in sufferers with frequent psychological issues like despair or anxiousness.
This info is critical to me as an optometrist, particularly in an OD-MD follow the place I’m referring a number of sufferers for cataract surgical procedure each day. Discussing enchancment in imaginative and prescient with the affected person and household is in the beginning, however discussing advantages of mitigation of future danger for falls, improved mobility or protecting impact on neurodegenerative illness will help in an earlier determination to maneuver ahead with surgical procedure. Whereas cataract surgical procedure stays very important for imaginative and prescient restoration, it might not provide the identical dementia-preventing benefits to sufferers with coexisting frequent psychological issues. This implies a necessity for a extra holistic method to affected person care, probably involving referrals for psychological well being help in these circumstances.
A key shortcoming of the examine, acknowledged by the authors, is its reliance on ICD-10-CM codes for diagnoses, which can introduce coding errors and restrict detailed info on elements like cataract severity, visible acuity or the specifics of psychological well being situations. Moreover, the 5-year follow-up interval, whereas substantial, leaves open the query of whether or not these conclusions maintain true over longer durations.
Alexander Martin, OD, FAAO
Boston Imaginative and prescient
This attitude is powered by the American Academy of Optometry Communications Committee.
Disclosures: Martin reviews no related monetary disclosures.
