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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2005 Jun;97(6):808–814.

Screening for cognitive impairment in older adults attending an eye clinic.

Mukaila A Raji 1, Rosa A Tang 1, Patricia C Heyn 1, Yong-Fang Kuo 1, Steven V Owen 1, Sonali Singh 1, Kenneth J Ottenbacher 1
PMCID: PMC2569493  PMID: 16035580

Abstract

PURPOSE: We conducted a cross-sectional study examining potentially modifiable factors associated with cognitive impairments (mild or severe) in older whites, African Americans and Hispanics attending an outpatient eye clinic. METHODS: In-clinic interviews and physical examinations assessed social, demographic and health information from 100 consecutive Hispanic, African-American and white adults aged > or = 55. Our primary outcome was presence of any cognitive impairment (mild or severe) using the St. Louis University Mental Status Examination (SLUMS) scale. RESULTS: Of the 100 subjects, 65 screened positive for cognitive impairments on the SLUMS cognitive instrument: 46 with mild cognitive impairment and 19 with severe impairment (possible dementia). African-American and Hispanic adults (nonwhites) were significantly more likely to have cognitive impairment compared to white adults (OR 2.80: 95% CI = 1.05-7.44), independent of age, years of education and systolic blood pressure. Subjects with diabetes also had increased odds of cognitive impairments (OR 3.28, 95% CI = 1.21-8.90) even after adjusting for relevant confounders. There was a nonsignificant trend between visual acuity impairment and cognitive impairment (p = 0.059). CONCLUSIONS: Sixty-five percent of adults aged > or = 55 attending the eye clinic screened positive for cognitive impairments, with higher rates among nonwhites and adults living with diabetes.

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Selected References

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  1. Banks William A., Morley John E. Memories are made of this: recent advances in understanding cognitive impairments and dementia. J Gerontol A Biol Sci Med Sci. 2003 Apr;58(4):314–321. doi: 10.1093/gerona/58.4.m314. [DOI] [PubMed] [Google Scholar]
  2. Biessels Geert Jan, Bravenboer Bert, Gispen Willem Hendrik. Glucose, insulin and the brain: modulation of cognition and synaptic plasticity in health and disease: a preface. Eur J Pharmacol. 2004 Apr 19;490(1-3):1–4. doi: 10.1016/j.ejphar.2004.02.057. [DOI] [PubMed] [Google Scholar]
  3. Demirovic Jasenka, Prineas Ronald, Loewenstein David, Bean Judy, Duara Ranjan, Sevush Steven, Szapocznik Jose. Prevalence of dementia in three ethnic groups: the South Florida program on aging and health. Ann Epidemiol. 2003 Jul;13(6):472–478. doi: 10.1016/s1047-2797(02)00437-4. [DOI] [PubMed] [Google Scholar]
  4. Fontbonne A., Berr C., Ducimetière P., Alpérovitch A. Changes in cognitive abilities over a 4-year period are unfavorably affected in elderly diabetic subjects: results of the Epidemiology of Vascular Aging Study. Diabetes Care. 2001 Feb;24(2):366–370. doi: 10.2337/diacare.24.2.366. [DOI] [PubMed] [Google Scholar]
  5. Giannakopoulos P., Gold G., Duc M., Michel J. P., Hof P. R., Bouras C. Neuroanatomic correlates of visual agnosia in Alzheimer's disease: a clinicopathologic study. Neurology. 1999 Jan 1;52(1):71–77. doi: 10.1212/wnl.52.1.71. [DOI] [PubMed] [Google Scholar]
  6. Grigsby Jim, Kaye Kaye, Shetterly Susan M., Baxter Judith, Morgenstern Nora E., Hamman Richard F. Prevalence of disorders of executive cognitive functioning among the elderly: findings from the San Luis Valley Health and Aging Study. Neuroepidemiology. 2002 Sep-Oct;21(5):213–220. doi: 10.1159/000065638. [DOI] [PubMed] [Google Scholar]
  7. Grodstein F., Chen J., Wilson R. S., Manson J. E., Nurses' Health Study Type 2 diabetes and cognitive function in community-dwelling elderly women. Diabetes Care. 2001 Jun;24(6):1060–1065. doi: 10.2337/diacare.24.6.1060. [DOI] [PubMed] [Google Scholar]
  8. Guralnik J. M. The impact of vision and hearing impairments on health in old age. J Am Geriatr Soc. 1999 Aug;47(8):1029–1031. doi: 10.1111/j.1532-5415.1999.tb01301.x. [DOI] [PubMed] [Google Scholar]
  9. Hofman A., Ott A., Breteler M. M., Bots M. L., Slooter A. J., van Harskamp F., van Duijn C. N., Van Broeckhoven C., Grobbee D. E. Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer's disease in the Rotterdam Study. Lancet. 1997 Jan 18;349(9046):151–154. doi: 10.1016/S0140-6736(96)09328-2. [DOI] [PubMed] [Google Scholar]
  10. Kalmijn S., Foley D., White L., Burchfiel C. M., Curb J. D., Petrovitch H., Ross G. W., Havlik R. J., Launer L. J. Metabolic cardiovascular syndrome and risk of dementia in Japanese-American elderly men. The Honolulu-Asia aging study. Arterioscler Thromb Vasc Biol. 2000 Oct;20(10):2255–2260. doi: 10.1161/01.atv.20.10.2255. [DOI] [PubMed] [Google Scholar]
  11. Kalmijn S., Launer L. J., Ott A., Witteman J. C., Hofman A., Breteler M. M. Dietary fat intake and the risk of incident dementia in the Rotterdam Study. Ann Neurol. 1997 Nov;42(5):776–782. doi: 10.1002/ana.410420514. [DOI] [PubMed] [Google Scholar]
  12. Kiyosawa M., Bosley T. M., Chawluk J., Jamieson D., Schatz N. J., Savino P. J., Sergott R. C., Reivich M., Alavi A. Alzheimer's disease with prominent visual symptoms. Clinical and metabolic evaluation. Ophthalmology. 1989 Jul;96(7):1077–1086. doi: 10.1016/s0161-6420(89)32769-2. [DOI] [PubMed] [Google Scholar]
  13. Landin K., Blennow K., Wallin A., Gottfries C. G. Low blood pressure and blood glucose levels in Alzheimer's disease. Evidence for a hypometabolic disorder? J Intern Med. 1993 Apr;233(4):357–363. doi: 10.1111/j.1365-2796.1993.tb00684.x. [DOI] [PubMed] [Google Scholar]
  14. Lee Andrew G., Beaver Hilary A., Jogerst Gerald, Daly Jeanette M. Screening elderly patients in an outpatient ophthalmology clinic for dementia, depression, and functional impairment. Ophthalmology. 2003 Apr;110(4):651–657. doi: 10.1016/S0161-6420(02)01901-2. [DOI] [PubMed] [Google Scholar]
  15. Levine D. N., Lee J. M., Fisher C. M. The visual variant of Alzheimer's disease: a clinicopathologic case study. Neurology. 1993 Feb;43(2):305–313. doi: 10.1212/wnl.43.2.305. [DOI] [PubMed] [Google Scholar]
  16. Lindeman R. D., Romero L. J., LaRue A., Yau C. L., Schade D. S., Koehler K. M., Baumgartner R. N., Garry P. J., New Mexico Elder Health Survey A biethnic community survey of cognition in participants with type 2 diabetes, impaired glucose tolerance, and normal glucose tolerance: the New Mexico Elder Health Survey. Diabetes Care. 2001 Sep;24(9):1567–1572. doi: 10.2337/diacare.24.9.1567. [DOI] [PubMed] [Google Scholar]
  17. Nestor Peter J., Scheltens Philip, Hodges John R. Advances in the early detection of Alzheimer's disease. Nat Med. 2004 Jul;10 (Suppl):S34–S41. doi: 10.1038/nrn1433. [DOI] [PubMed] [Google Scholar]
  18. Parker Chris, Philp Ian. Screening for cognitive impairment among older people in black and minority ethnic groups. Age Ageing. 2004 Jun 24;33(5):447–452. doi: 10.1093/ageing/afh135. [DOI] [PubMed] [Google Scholar]
  19. Sadun A. A., Bassi C. J. Optic nerve damage in Alzheimer's disease. Ophthalmology. 1990 Jan;97(1):9–17. doi: 10.1016/s0161-6420(90)32621-0. [DOI] [PubMed] [Google Scholar]
  20. Sommer A., Tielsch J. M., Katz J., Quigley H. A., Gottsch J. D., Javitt J. C., Martone J. F., Royall R. M., Witt K. A., Ezrine S. Racial differences in the cause-specific prevalence of blindness in east Baltimore. N Engl J Med. 1991 Nov 14;325(20):1412–1417. doi: 10.1056/NEJM199111143252004. [DOI] [PubMed] [Google Scholar]
  21. Sparks D. L. Coronary artery disease, hypertension, ApoE, and cholesterol: a link to Alzheimer's disease? Ann N Y Acad Sci. 1997 Sep 26;826:128–146. doi: 10.1111/j.1749-6632.1997.tb48466.x. [DOI] [PubMed] [Google Scholar]
  22. Taubes Gary. Neuroscience. Insulin insults may spur Alzheimer's disease. Science. 2003 Jul 4;301(5629):40–41. doi: 10.1126/science.301.5629.40. [DOI] [PubMed] [Google Scholar]
  23. Tielsch J. M., Sommer A., Katz J., Royall R. M., Quigley H. A., Javitt J. Racial variations in the prevalence of primary open-angle glaucoma. The Baltimore Eye Survey. JAMA. 1991 Jul 17;266(3):369–374. [PubMed] [Google Scholar]
  24. Trick G. L., Trick L. R., Morris P., Wolf M. Visual field loss in senile dementia of the Alzheimer's type. Neurology. 1995 Jan;45(1):68–74. doi: 10.1212/wnl.45.1.68. [DOI] [PubMed] [Google Scholar]
  25. Warren S., Hier D. B., Pavel D. Visual form of Alzheimer's disease and its response to anticholinesterase therapy. J Neuroimaging. 1998 Oct;8(4):249–252. doi: 10.1111/jon199884249. [DOI] [PubMed] [Google Scholar]
  26. Washburn R. A., Smith K. W., Jette A. M., Janney C. A. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993 Feb;46(2):153–162. doi: 10.1016/0895-4356(93)90053-4. [DOI] [PubMed] [Google Scholar]

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