Elderly with Untreated Vision Problem More Likely to Develop Alzheimer’s

Elderly people with visual disorders that are left untreated are significantly more likely to develop Alzheimer’s disease — the most common form of dementia, according to a University of Michigan Health System study.

The study used Medicare data and shows that those with poor vision who visited an ophthalmologist at least once for an examination were 64 percent less likely to develop dementia.

The study appears online ahead of print in the American Journal of Epidemiology and may draw a new picture of poor vision as predictor of dementia rather than as a symptom after the diagnosis.

“Visual problems can have serious consequences and are very common among the elderly, but many of them are not seeking treatment,” says lead author Mary A.M. Rogers, Ph.D, research assistant professor of internal medicine at the U-M Medical School and research director of the Patient Safety Enhancement Program at the U-M Health System and the Ann Arbor VA Medical Center.

For the study, Rogers and her colleague Kenneth M. Langa, M.D., Ph.D., professor of internal medicine at U-M Medical School, analyzed data from the nationally representative Health and Retirement Study and records from Centers for Medicare and Medicaid Services.

”Our results indicate that it is important for elderly individuals with visual problems to seek medical attention so that the causes of the problems can be identified and treated,” Rogers says.

The types of vision treatment that were helpful in lowering the risk of dementia were surgery to correct cataracts and treatments for glaucoma, retinal disorders and other eye-related problems.

Proper vision is a requirement for many of the activities that previously have been found to lower the risk of Alzheimer’s disease. These include reading, playing board games, other mentally stimulating activities, social networking, as well as physical activity such as walking and routine exercising. A visual disorder may interfere with normal mobility and may also hinder a person’s ability to participate in such activities.

“Many elderly Americans do not have adequate health coverage for vision, and Medicare does not cover preventative vision screenings for most beneficiaries,” Rogers says. “So it’s not unusual that the elderly receive vision treatment only after a problem is severe enough to warrant a visit to the doctor when the problem is more advanced.”

According to a survey conducted by the National Eye Health Education Program, less than 11 percent of respondents understood that there are no early warning signs for eye problems such as glaucoma and diabetic retinopathy.

However, vision problems and blindness are among the top 10 disabilities among adults and can result in a greater tendency to experience other health conditions or even to die prematurely.

“While heart disease and cancer death rates are continuing to decline, mortality rates for Alzheimer’s disease are on the rise,” says Rogers. “So if we can delay the onset of dementia, we can save individuals and their families from the stress, cost and burden that are associated with Alzheimer’s disease.”

The study was based on the surveys and medical information from 625 people compiled from 1992-2005. Only 10 percent of Medicare beneficiaries who developed dementia had excellent vision at the beginning of the study, while 30 percent of those who maintained normal cognition had excellent vision at the onset of the study.

One in five Americans who are over age 50 report experiencing a visual impairment, according to the U.S. Centers for Disease Control and Prevention. Approximately 5 million Americans have Alzheimer’s disease and the number has doubled since 1980. It is expected to be as high as 13 million by 2050.

Source: American Journal of Epidemiology,/em> 2010 Feb. 11; doi:10.1093; University of Michigan

Eye Scan May Help Early Diagnosis of Multiple Sclerosis (MS)

Researchers have found that a five-minute eye exam called optical coherence tomography (OCT) that measures optic nerve damage may aide in spotting multple sclerosis (MS) early, as well as help track the progression of the disease.

While the definitive cause of MS is not known, most scientists believe that MS is an auto-immune disease, where the body’s immune system attacks the nervous system.

Currently, MS is diagnosed by patient history, clinical exams, and laboratory tests. The National MS Society says the preferred test, which detects plaques or scarring that may be caused by MS, is magnetic resonance imaging or an MRI.

In the OCT study, 40 multiple sclerosis (MS) patients underwent OCT scans. The results suggested an association between the retinal measurement and brain atrophy.

According to Johns Hopkins neurologist Peter Calabresi, M.D., an MRI "measures the result of many types of tissue loss rather than specifically nerve damage itself. With OCT we can see exactly how healthy these nerves are, potentially in advance of other symptoms."

OCT scans are also much faster and less expensive than MRI scans.

Dr. Calabresi adds that many of the MS symptoms, such as numbness, tingling, visual impairment, fatigue, weakness and bladder function disturbance, are the result of nerve cell degeneration, so a test that specifically measures nerve cell health is potentially the clearest picture of the status of the disease, though optic nerve damage can point to a number of diseases and is not a unique diagnostic tool for MS.

The National MS Society estimates that about 400,000 people have Multiple Sclerosis.

The study was published in the October, 2007 issue of Neurology.

Source: Johns Hopkins University

Vision and Hearing Impairment May Contribute to Depression in Seniors

It is commonly known that hearing and vision impairment are much more pronounced in the elderly population. With the gradual onset of hearing and vision loss, certain tasks become more difficult for seniors.

In addition to the direct difficulties, such as having trouble reading smaller type or understanding conversations, hearing and vision loss is also associated with the development of mood disorders, according to Dennis Norman, Chief of Psychology at Massachusetts General Hospital.

"Vision and hearing loss are major public health issues because they affect so many older individuals, and because they have an adverse impact on mental health," says Norman. "If the senses are limited, everything is affected, including interaction with surroundings, relationships, activities, and feelings of self-worth. Impairment can lead to depression, anxiety, social isolation and many other problems."

According to the Centers for Disease Control, approximately 3.6 million Americans over the age of 70 have impaired vision, and 6.7 million older adults report impaired hearing.

The CDC also indicates that these individuals also are more likely to experience problems in other activities of daily life, such as walking, going outdoors, getting in and out of chairs or bed, or managing their prescription medications. They are also less likely to socialize than individuals without sensory impairment.

A recent study reported in Archives of Ophthalmology (April 2006) also suggests that there’s a significant link between visual problems and thinking, memory and learning.

Hearing impairment has also been linked to cognitive decline. Brandeis University researchers suggest that mental resources are expended toward efforts to hear, at the expense of memory.

Preventive Measures to Protect from Hearing and Vision Impairment

  • Wear sunglasses to reduce exposure to UV radiation
  • Protect ears by avoiding loud noises, wearing earplugs, and keep earphone volume down
  • Stay healthy with regular medical checkups, quitting smoking, and managing conditions such as diabetes and high blood pressure that can damage eyes and/or ears.
  • Maintain a healthful diet: Get plenty of vitamin C through citrus fruits and juices; eat carrots and dark-green leafy vegetables such as spinach for beta-carotene; eat whole grains, nuts, and eggs for vitamin E; and get needed zinc from fish, meats, whole grains and dairy products. For nutrients that strengthen or protect hearing, eat foods rich in: vitamin D (fortified dairy products, seafood, fortified cereals); vitamin B12 (meat, poultry, eggs, dairy products and shellfish); and folate (liver, eggs, beans, fortified cereals, leafy green vegetables, and fruits).
  • Consider supplements. Ask your doctor about taking supplements such as bilberry (huckleberry), ginkgo biloba and vinpocetine.

Helpful Resources
These groups offer support and information to help people cope with hearing and vision impairment:

Source: Newswise

Fish Oil May Protect Premature Babies’ Eyesight

Perhaps nowhere in the body is the adage “you are what you eat” so true as in your eyes, a link scientists are banking on in a novel bid to save premature babies’ vision.

Doctors are about to begin testing whether fish oils could prevent a disease that can silently attack behind preemies’ tiny eyelids, one that strikes about 16,000 U.S. infants a year and blinds hundreds.

It’s part of research into a trio of apparently eye-healthy compounds that babies born too early miss absorbing from their mothers — research gaining increasing attention as more and babies are born premature and at risk.