Cataract Surgery Lowers Risk of AD

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Plumster
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Cataract Surgery Lowers Risk of AD

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Question Is cataract extraction associated with reduced risk of developing dementia?

Findings In this cohort study assessing 3038 adults 65 years of age or older with cataract enrolled in the Adult Changes in Thought study, participants who underwent cataract extraction had lower risk of developing dementia than those who did not have cataract surgery after controlling for numerous additional risks. In comparison, risk of dementia did not differ between participants who did or did not undergo glaucoma surgery, which does not restore vision.

Meaning This study suggests that cataract extraction is associated with lower risk of developing dementia among older adults.

Abstract
Importance Visual function is important for older adults. Interventions to preserve vision, such as cataract extraction, may modify dementia risk.

Objective To determine whether cataract extraction is associated with reduced risk of dementia among older adults.

Design, Setting, and Participants This prospective, longitudinal cohort study analyzed data from the Adult Changes in Thought study, an ongoing, population-based cohort of randomly selected, cognitively normal members of Kaiser Permanente Washington. Study participants were 65 years of age or older and dementia free at enrollment and were followed up biennially until incident dementia (all-cause, Alzheimer disease, or Alzheimer disease and related dementia). Only participants who had a diagnosis of cataract or glaucoma before enrollment or during follow-up were included in the analyses (ie, a total of 3038 participants). Data used in the analyses were collected from 1994 through September 30, 2018, and all data were analyzed from April 6, 2019, to September 15, 2021.

Exposures The primary exposure of interest was cataract extraction. Data on diagnosis of cataract or glaucoma and exposure to surgery were extracted from electronic medical records. Extensive lists of dementia-related risk factors and health-related variables were obtained from study visit data and electronic medical records.

Main Outcomes and Measures The primary outcome was dementia as defined by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Multivariate Cox proportional hazards regression analyses were conducted with the primary outcome. To address potential healthy patient bias, weighted marginal structural models incorporating the probability of surgery were used and the association of dementia with glaucoma surgery, which does not restore vision, was evaluated.

Results In total, 3038 participants were included (mean [SD] age at first cataract diagnosis, 74.4 (6.2) years; 1800 women (59%) and 1238 men (41%); and 2752 (91%) self-reported White race). Based on 23 554 person-years of follow-up, cataract extraction was associated with significantly reduced risk (hazard ratio, 0.71; 95% CI, 0.62-0.83; P < .001) of dementia compared with participants without surgery after controlling for years of education, self-reported White race, and smoking history and stratifying by apolipoprotein E genotype, sex, and age group at cataract diagnosis. Similar results were obtained in marginal structural models after adjusting for an extensive list of potential confounders. Glaucoma surgery did not have a significant association with dementia risk (hazard ratio, 1.08; 95% CI, 0.75-1.56; P = .68). Similar results were found with the development of Alzheimer disease dementia.

Conclusions and Relevance This cohort study found that cataract extraction was significantly associated with lower risk of dementia development. If validated in future studies, cataract surgery may have clinical relevance in older adults at risk of developing dementia.

The study can be found here
A reader-friendly article is here
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thumperama
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Re: Cataract Surgery Lowers Risk of AD

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Thanks, plumster. I noted : “ the only covariate that was more protective than cataract surgery was not having an APOE e4 allele”, referring to Figure 2.
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Re: Cataract Surgery Lowers Risk of AD

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It looks like we need to keep as much sensory information flowing to the brain as possible. Hearing loss is also a big risk factor in dementia.
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Re: Cataract Surgery Lowers Risk of AD

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Quantifier wrote: Tue Dec 14, 2021 8:40 am It looks like we need to keep as much sensory information flowing to the brain as possible. Hearing loss is also a big risk factor in dementia.
Yes, that was my conclusion as well. I need to wear my glasses all the time, not just some of the time. :ugeek:
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CAngelS
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Re: Cataract Surgery Lowers Risk of AD

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Plumster wrote: Thu Dec 16, 2021 11:36 am
Quantifier wrote: Tue Dec 14, 2021 8:40 am It looks like we need to keep as much sensory information flowing to the brain as possible. Hearing loss is also a big risk factor in dementia.
Yes, that was my conclusion as well. I need to wear my glasses all the time, not just some of the time. :ugeek:
thumperama wrote: Tue Dec 14, 2021 12:09 am Thanks, plumster. I noted : “ the only covariate that was more protective than cataract surgery was not having an APOE e4 allele”, referring to Figure 2.
94AC029C-C235-4355-865C-7F828D908996.jpeg

Making a note of this for the future! Thanks for sharing.

This thread also prompted me to look around more on the forum where I found Julie_G & Tincup’s vision improvement stories, also (primarily from non-UV exposure to sunlight, and in Julie’s case, grass-fed liver). Fascinating.
Tincup wrote: Fri May 11, 2018 7:45 pm
Julie G wrote:First, based on Tincup's recommendations, I've been purposefully exposing my eyes to light outdoors rarely wearing sunglasses. (He has a dramatic vision improvement story using this strategy that I hope he'll share.)
In October 2016, my integrative eye doc told me to ditch the sunglasses, she didn't think the studies were good (I realize this is totally against standard of care, so do your own research before you follow my lead). She tested my uncorrected vision at 20:200 (feet here in the US), I followed her advice and started trying to get outside a) in the hour after sunrise gazing in the direction (not at) the sun for a few minutes (and wearing only shorts and barefoot, even in the snow) without glasses, contacts or anything (most will block uv) and b) walking outside around noon (I live just below 40 deg N latitude at 5,600') for 40 minutes to an hour, again with naked eyes (and typically only shorts & barefoot, even in the snow). I take my goggles off when on the lift, skiing on sunny days at 12,000'. In February 2018, she tested my uncorrected vision at 20:80. I'm nearly 63. She said my eyes look great, no signs of cataract or AMD and that all the vessels and eye structures look excellent. She also told me I'm the only patient that follows her advice. I'm like a kid with a new toy as while 20:80 is far from perfect, I can function without needing correction in many circumstances (also on a home printed eye chart, my vision is nearly 20:60 now, several months later).
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Plumster
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Re: Cataract Surgery Lowers Risk of AD

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CAngelS wrote: Sat Jan 22, 2022 9:43 am
Plumster wrote: Thu Dec 16, 2021 11:36 am
Quantifier wrote: Tue Dec 14, 2021 8:40 am It looks like we need to keep as much sensory information flowing to the brain as possible. Hearing loss is also a big risk factor in dementia.
Yes, that was my conclusion as well. I need to wear my glasses all the time, not just some of the time. :ugeek:
thumperama wrote: Tue Dec 14, 2021 12:09 am Thanks, plumster. I noted : “ the only covariate that was more protective than cataract surgery was not having an APOE e4 allele”, referring to Figure 2.
94AC029C-C235-4355-865C-7F828D908996.jpeg


Making a note of this for the future! Thanks for sharing.

This thread also prompted me to look around more on the forum where I found Julie_G & Tincup’s vision improvement stories, also (primarily from non-UV exposure to sunlight, and in Julie’s case, grass-fed liver). Fascinating.
Tincup wrote: Fri May 11, 2018 7:45 pm
Julie G wrote:First, based on Tincup's recommendations, I've been purposefully exposing my eyes to light outdoors rarely wearing sunglasses. (He has a dramatic vision improvement story using this strategy that I hope he'll share.)
In October 2016, my integrative eye doc told me to ditch the sunglasses, she didn't think the studies were good (I realize this is totally against standard of care, so do your own research before you follow my lead). She tested my uncorrected vision at 20:200 (feet here in the US), I followed her advice and started trying to get outside a) in the hour after sunrise gazing in the direction (not at) the sun for a few minutes (and wearing only shorts and barefoot, even in the snow) without glasses, contacts or anything (most will block uv) and b) walking outside around noon (I live just below 40 deg N latitude at 5,600') for 40 minutes to an hour, again with naked eyes (and typically only shorts & barefoot, even in the snow). I take my goggles off when on the lift, skiing on sunny days at 12,000'. In February 2018, she tested my uncorrected vision at 20:80. I'm nearly 63. She said my eyes look great, no signs of cataract or AMD and that all the vessels and eye structures look excellent. She also told me I'm the only patient that follows her advice. I'm like a kid with a new toy as while 20:80 is far from perfect, I can function without needing correction in many circumstances (also on a home printed eye chart, my vision is nearly 20:60 now, several months later).
Yes, and also red light therapy (photobiomodulation), as have been referenced on this forum. I use red light therapy and noticed a slight change with my eyes.
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Re: Cataract Surgery Lowers Risk of AD

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Plumster wrote: Sat Jan 22, 2022 9:46 am Yes, and also red light therapy (photobiomodulation), as have been referenced on this forum. I use red light therapy and noticed a slight change with my eyes.
I’ve seen photobiomodulation mentioned, but I don't know anything about it, really. I’ll read up. Thanks, Plumster!
"If you are kind only to your friends, how are you different from anyone else?" (Matthew 5:47)
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