The Effect of Cataract Surgery on Cognitive Function in Elderly Adults

So Young Park; Sangkyung Choi

doi:10.3341/jkos.2019.60.1.25

Journal List > J Korean Ophthalmol Soc > v.60(1) > 1111830

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Park and Choi: The Effect of Cataract Surgery on Cognitive Function in Elderly Adults

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(1): 25-31.

Published online: 16 January 2019

DOI: https://doi.org/10.3341/jkos.2019.60.1.25

The Effect of Cataract Surgery on Cognitive Function in Elderly Adults

So Young Park, MD, Sangkyung Choi, MD, PhD

Department of Ophthalmology, Veterans Health Service Medical Center, Seoul, Korea.

Address reprint requests to Sangkyung Choi, MD, PhD. Department of Ophthalmology, Veterans Health Service Medical Center, #53 Jinhwangdo-ro 61-Gil, Gangdong-Gu, Seoul 05368, Korea. Tel: 82-2-2225-1379, Fax: 82-2-2225-1485, drskchoi@hanmail.net

Received 28 June 2018 Revised 29 August 2018 Accepted 28 December 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the correlation between cataract surgery and cognitive function using the Korean-mini mental state Examination (K-MMSE).

Methods

We performed cataract extraction with phacoemulsification and intraocular lens implantation in 138 eyes of 87 patients, from 2014 to 2016, with subjective cognitive complaints. K-MMSE was used to measure cognitive function of the patients before and after surgery, and the results were analyzed using the paired t-test.

Results

The mean age of the patients was 76.09 ± 6.52 years. The preoperative mean K-MMSE score was 23.44 ± 4.12 and the postoperative mean K-MMSE score was 24.49 ± 3.19. The increase in the postoperative K-MMSE score from that of the preoperative score was significant. Among the 87 patients who participated in the study, 36 patients were treated with unilateral cataract surgery and 51 patients were treated with bilateral cataract surgery. The mean ages were 76.36 ± 6.68 years and 75.90 ± 6.47 years, respectively. The mean K-MMSE scores significantly increased in both unilateral and bilateral patients (0.91 ± 1.96 and 1.15 ± 2.73 points, respectively). The difference in the increase in the mean K-MMSE score was not significant between the two groups. When analyzed according to the K-MMSE score, only those who initially scored < 23 points showed significant improvement in cognition function, which was not associated with the improvement in the best-corrected visual acuity improvement.

Conclusions

There was an improvement of the K-MMSE score after cataract surgery, indicating that cataract surgery not only enhanced visual acuity but also had a positive effect on the patients' cognitive function. When considering cataract surgery in older patients, this improvement in cognition could lead to a better life, which should be taken into consideration.

Keywords: Cataract, Cognitive function, Korean-mini mental state examination (K-MMSE)

Figures and Tables

Figure 1

Comparison of preoperative and postoperative K-MMSE score in unilateral cataract patients. ‘high score patients’ means ‘K-MMSE score more than 24, including 24’, and ‘Low score patients’ means ‘K-MMSE score less than 23, including 23’. K-MMSE = Korean mini-mental state examination; Pre-op = preoperative; Post-op = postoperative.

Table 1

Demographic characteristics of study patients (87 patients)

Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.

M/F = male/female; Pre-op = preoperative; BCVA = best corrected visual acuity; Post-op = postoperative.

^*Measured using independent t-test; ^†Measured using Chi-square test.

Table 2

Comparison of preoperative and postoperative BCVA and K-MMSE score of study patients (87 patients)

Values are presented as mean ± standard deviation.

BCVA = best corrected visual acuity; Pre-op = preoperative; Post-op = postoperative; K-MMSE = Korean mini-mental state examination.

^*Measured using paired t-test.

Table 3

Comparison of preoperative and postoperative BCVA between high K-MMSE score patients and low K-MMSE score patients in unilateral cataract patients

Values are presented as mean ± standard deviation. ‘High score patients’ means ‘K-MMSE score more than 24, including 24’, and ‘Low score patients’ means ‘K-MMSE score less than 23, including 23’.

BCVA = best corrected visual acuity; K-MMSE = Korean mini-mental state examination; Pre-op BCVA = preoperative BCVA; Post-op = postoperative BCVA; Post-op - Pre-op = score difference between preoperative and postoperative.

^*Measured using independent t-test.

Table 4

Comparison of preoperative and postoperative BCVA between high K-MMSE score patients and low K-MMSE score patients in bilateral cataract patients

Values are presented as mean ± standard deviation or number. ‘High score patients’ means ‘K-MMSE score more than 24, including 24’, and ‘Low score patients’ means ‘K-MMSE score less than 23, including 23’.

^*Measured using independent t-test.

Table 5

Comparison of preoperative and postoperative K-MMSE score between unilateral cataract patients and bilateral cataract patients

Values are presented as mean ± standard deviation or number.

K-MMSE = Korean mini-mental state examination; Pre-op = preoperative K-MMSE score; Post-op = postoperative K-MMSE score; Post-op - Pre-op = score difference between preoperative and postoperative K-MMSE.

^*Measured using independent t-test.

Notes

This study was supported by a VHS Medical Center Research Grant, Republic of Korea (grant number: VHSMC 18018).

^{Conflicts of Interest} The authors have no conflicts to disclose.

References

1. Resnikoff S, Pascolini D, Etya’ale D, et al. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004; 82:844–851.

2. Rim TH, Kim MH, Kim WC, et al. Cataract subtype risk factors identified from the Korea National Health and Nutrition Examination survey 2008-2010. BMC Ophthalmol. 2014; 14:4.

3. Sachdev PS, Blacker D, Blazer DG, et al. Classifying neurocognitive disorders: the DSM-5 approach. Nat Rev Neurol. 2014; 10:634–642.

4. Kim YJ, Han JW, So YS, et al. Prevalence and trends of dementia in Korea: a systematic review and meta-analysis. J Korean Med Sci. 2014; 29:903–912.

5. Anstey KJ, Luszcz MA, Sanchez L. Two-year decline in vision but not hearing is associated with memory decline in very old adults in a population-based sample. Gerontology. 2001; 47:289–293.

6. Reischies FM. Age-related cognitive decline and vision impairment affecting the detection of dementia syndrome in old age. Br J Psychiatry. 1997; 171:449–451.

7. Kempen JH, Krichevsky M, Feldman S. Effect of visual impairment on neuropsychological test performance. J Clin Exp Neuropsychol. 1994; 16:223–231.

8. Kang Y, Na DL, Hahn SH. A validity study on the Korean minimental state examination (K-MMSE) in dementia patients. J Korean Neurol Assoc. 1997; 15:300–308.

9. Hall TA, McGwin G Jr, Owsley C. Effect of cataract surgery on cognitive function in older adults. J Am Geriatr Soc. 2005; 53:2140–2144.

10. Grodstein F, Chen J, Hankinson SE. Cataract extraction and cognitive function in older women. Epidemiology. 2003; 14:493–497.

11. Tamura H, Tsukamoto H, Mukai S, et al. Improvement in cognitive impairment after cataract surgery in elderly patients. J Cataract Refract Surg. 2004; 30:598–602.

12. Ishii K, Kabata T, Oshika T. The impact of cataract surgery on cognitive impairment and depressive mental status in elderly patients. Am J Ophthalmol. 2008; 146:404–409.

13. Jefferis JM, Clarke MP, Taylor JP. Effect of cataract surgery on cognition, mood, and visual hallucinations in older adults. J Cataract Refract Surg. 2015; 41:1241–1247.

14. Gray CS, Karimova G, Hildreth AJ, et al. Recovery of visual and functional disability following cataract surgery in older people: Sunderland Cataract Study. J Cataract Refract Surg. 2006; 32:60–66.

15. Yu WK, Chen YT, Wang SJ, et al. Cataract surgery is associated with a reduced risk of dementia: a nationwide population-based cohort study. Eur J Neurol. 2015; 22:1370–1377.

16. Miyata K, Yoshikawa T, Morikawa M, et al. Effect of cataract surgery on cognitive function in elderly: results of Fujiwara-kyo Eye Study. PLoS One. 2018; 13:e0192677.

17. Kondratova AA, Kondratov RV. The circadian clock and pathology of the ageing brain. Nat Rev Neurosci. 2012; 13:325–335.

18. Ayaki M, Muramatsu M, Negishi K, Tsubota K. Improvements in sleep quality and gait speed after cataract surgery. Rejuvenation Res. 2013; 16:35–42.

19. Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12:189–198.

TOOLS

Similar articles