OBJECTIVES:

The analysis aims to identify survival rate and relative risk of patients with dementia, in association with vision impairment (VI) and other significant confounding comorbidities. A stratified analysis of time to event for subgroups representing different age groups, demography and comorbidities was performed.

METHODS:

A total of 65,878 patients aged 61 years and older were included using Optum’s de-identified Clinformatics Data Mart Database. This cohort included all patients with VI, who may or may not have developed dementia, were identified & followed for a period of five years (2015-2020). Patient with one inpatient or two outpatient (60 days apart) diagnosis of VI were included in the analysis.

CP hazard regression model and Kaplan-Meier curves were used to evaluate the impact of baseline VI on subsequent dementia. Potential confounders for the analysis included coronary heart disease, stroke, hearing loss, hypertension, diabetes, myocardial-infraction, and demographic characteristics. The variable age was grouped in 5-year intervals, spanning across 65 to 90 years and older.

RESULTS:

Among patients with VI, 23% reported having dementia. Age, coronary heart disease, stroke, hearing loss, hypertension and myocardial infraction were also found to be highly significant contributors (P<0.001) for developing dementia. It was observed that a higher relative risk for coronary heart disease (RR:1.9) followed by stroke(RR:1.4) existed among all other comorbidities to develop dementia. In addition, relative risk in race for developing dementia with baseline VI was highest for African Americans (RR:1.1).

The significance of survival curve was established using log rank test (P<0.01). Survival forest model with 500 iterations signifies age as highly important factor for dementia, followed by coronary heart disease, stroke and hypertension.

CONCLUSIONS:

VI in the US Medicare population is associated with a greater likelihood for dementia over time. Associations are multifactorial, and the risk of developing dementia is higher for patient having more than one comorbidity.