Is It Memory Loss, or an Undiagnosed Vision Problem?
Routine cognitive screenings are often administered to older patients—and if the test shows a problem, the patient may be advised to seek a neurological evaluation. This can cause a lot of anxiety.
However, a research team from Australia recently demonstrated that when older adults score poorly on a cognitive test, their thinking might not be the problem. “Cognitive tests that rely on vision-dependent tasks could be skewing results in up to a quarter of people aged over 50 who have undiagnosed visual problems such as cataracts or age-related macular degeneration (AMD),” noted the experts from the University of South Australia.
The team, led by Ph.D. candidate Anne Macnamara, administered cognitive tests to a group of seniors, and found that those with vision problems might do just fine on verbal tests, but not on vision-dependent tests. “The results are a stark reminder that visual impairments—which affect approximately 200 million people worldwide over the age of 50—unfairly affect cognitive scores when tests involve visual abilities.”
Macnamara said that when a person is already dealing with vision loss and then must cope with a dementia diagnosis, this can be very stressful. “A mistaken score in cognitive tests could have devastating ramifications, leading to unnecessary changes to a person’s living, working, financial or social circumstances,” she noted. “For example, if a mistaken score contributed to a diagnosis of mild cognitive impairment, it could trigger psychological problems including depression and anxiety.”
And this mistaken diagnosis could have an added consequence if vision problems are overlooked and the patient doesn’t receive a prompt evaluation of their vision problems—such a loss when many vision problems that are common among older adults can be treated.
- Glaucoma, often called “the sneak thief of sight,” is caused by a buildup of fluid in the front of the eye. It causes gradual—and in some cases, rapid—vision loss. A simple eye exam is used to detect the condition early, and eye drops and other treatments can prevent loss of eyesight.
- Age-related macular degeneration (AMD) causes the deterioration of the center area of vision that we use for reading, driving, and recognizing faces. Not so long ago, there was little doctors could do for wet AMD, the more severe type of this condition. But today, painless injections are available to slow, and in some cases reverse, vision loss from wet AMD.
- Cataracts happen when the lens of the eye becomes cloudy, causing blurry, dull and dim vision. Today, cataract surgery can almost be considered routine—and public health experts say this surgery is a contributing factor to the longer life expectancy of people today. According to University of Washington School of Medicine experts, there is even strong evidence that cataract surgery dramatically lowers a person’s risk of developing dementia.
- Diabetic eye disease affects about one-third of older adults who have diabetes. They are at higher risk of glaucoma and cataracts, and may develop retinal problems, as well. Treatment depends on the type of diabetic eye disease a person has, and may slow or improve their vision loss.
Seeking prompt treatment for eye conditions also protects the brain. Low vision is stressful. It can lead to depression, isolation and loneliness, boredom and a lack of mental stimulation, all of which raise the risk of dementia. It raises the risk of head injuries. The National Eye Institute describes it like this: “Activities that used to be fun and fulfilling may begin to seem burdensome or even impossible. With loss of the ability to drive and navigate unfamiliar places, it becomes easier to stay at home than to see friends or meet new people. All of this can take a toll on mental health and lead to clinical depression.”
Here are tips to protect your vision:
- Have regular dilated eye exams, as recommended by your doctor.
- Eat a healthy diet.
- If you smoke, quit.
- If you drink alcohol, do so only in moderation.
- Get adequate exercise.
- Protect your eyes from the sun.
- Be sure your eyeglass prescription is kept up to date.
Living with vision loss
If you have impaired eyesight, there are many ways to compensate, which can allow you to continue to live a fulfilling life with as much independence as possible. Ask your doctor about low vision rehabilitation, where you can learn new ways of doing things, be trained in the use of a wide array of innovative adaptive devices, make home modifications for safety and convenience, and find support.
The vision rehab team might include your optometrist or ophthalmologist, occupational therapists, orientation and mobility specialists, certified low-vision therapists, assistive technology professionals and social workers. With the help of low vision support, people living with vision loss can continue to lead a vibrant, connected life.
The information in this article is not intended to take the place of your doctor’s advice. Talk to your vision care professional or other health care provider about your eye health.