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Visual Impairment May Be Early Dementia Risk Factor Visual impairment may be a risk factor for dementia, according to a study published in JAMA Ophthalmology. In this study women with baseline objective visual impairment were more likely to develop dementia after an average follow-up of 3.8 years. Researchers notes that self-reported visual impairment was not associated with any risk of dementia or MCI (Mild Cognitive Impairment). However, data showed “visual impairment was associated with an even higher likelihood of dementia when combined with self-reported hearing loss.” The researchers found women with visual acuity of 20/100 or worse at baseline were at the greatest risk for developing dementia. When it comes to the risk of developing MCI (Mild Cognitive Impairment), this group also had the greatest risk. The results suggest interventions to improve visual acuity in older adults may be beneficial. “Older adults who undergo cataract surgery have been suggested to have lower risk of new-onset dementia, and other studies have suggested improved cognitive scores after cataract surgery”. Here are a few examples of warning signs that may be a tell tale presentation that may lead to visual complications. Consult with your nursing team if your resident either displays or complains of the following: Sudden eye pain: redness and nausea – this could mean a sudden but severe bout of narrow-angle glaucoma and may lead to vision loss. Spots and floaters in his/her field of vision: This may be due to the separation of the gel-like interior of the eye from the retina and is a normal part of aging. However, if symptoms are sudden or associated with ongoing flashes of light your resident could be presenting with a tear or detachment of the retina. Surface pain, tearing, or irritation: May be symptoms of dry eye syndrome, a condition that is more annoying than sight-threatening. Double vision: This is an important symptom, which should not be ignored. Dark curtain sensation across the visual field: If this is temporary, disappearing after a few seconds or minutes, then it would be important to check for a mini-stroke. Although many previous studies have reported associations between visual impairment and impaired cognition, evidence has been mixed. Individuals with visual impairment may perform poorly on cognitive tests, especially tests with visual components. Individuals with visual impairment may experience less cognitive stimulation thus, progressively decline, emotionally retreat or simply lose interest in the world around them. It boils down to the old adage: “Use it or lose it!” That said, prevention, early detection, and management are key priorities as population aging leads to rapid growth in dementia prevalence. In particular, identifying potentially modifiable risk factors is essential to ensure that patients have access to interventions and support when they are most able to benefit. According to the researchers in this study, the results suggest interventions to improve visual acuity in older adults may be beneficial. These findings suggest potential value for early vision screening and vision-improving interventions. Facilities must care plan and customize resident programming to ensure that residents with sight limitations are given appropriated adaptations to continue to finding pleasure and thus, a reason to fully participate in cognitively stimulating opportunities. Those of you that are managing therapeutic interest and needs based programming are likely to be spending more overall quantitative time with the aging population you serve than any other interdisciplinary healthcare professionals and as such, you will not only get to know your resident’s psychosocial frame of mind but will undoubtedly become acutely aware of your resident’s clinical diagnosis. The degree of time you spend in direct contact with your resident puts you at a vantage point for spotting those subtle nuances or even perhaps minuet changes that could actually be red flag warnings of an impending clinical and/or behavioral issues to seek nursing consultation for. https://www.medicaloptics.ie/ten-warning-signs-of-vision-problems-in-the-elderly/ https://www.ajmc.com/view/visual-impairment-may-be-early-dementia-risk-factor https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2764384? Have a topic request or question for Celeste? 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