A new study from the University of South Australia shows that millions of older people with poor vision are at risk of being wrongly diagnosed with mild cognitive impairments.

Cognitive assessments that rely on vision-dependent tasks may be skewing findings in up to a quarter of adults over 50 who have undiagnosed visual impairments such as cataracts or age-related macular degeneration (AMD).

Age-related macular degeneration (AMD) is the major cause of visual loss in the elderly. It does not result in total blindness, but it has a significant influence on people’s ability to read, drive, cook, and even recognize faces. It makes no difference to intellect.

24 people with normal vision were recruited by UniSA researchers to perform two cognitive tests: one requiring vision-dependent reaction tasks and the other based on verbal fluency.

The individuals performed much worse on the cognitive test requiring reaction time tasks when wearing goggles to imitate AMD. When utilizing the goggles, there was no statistical change in verbal fluency assessments.

The findings of the study were published in Scientific Reports.

The findings, according to UniSA PhD candidate Anne Macnamara, are a clear reminder that visual impairments, which affect about 200 million persons over the age of 50 worldwide, adversely influence cognitive scores when examinations entail visual ability.

“A mistaken score in cognitive tests could have devastating ramifications, leading to unnecessary changes to a person’s living, working, financial or social circumstances,” said the author.

“For example, if a mistaken score contributed to a diagnosis of mild cognitive impairment, it could trigger psychological problems including depression and anxiety.

“People with AMD are already experiencing multiple issues due to vision loss and an inaccurate cognitive assessment is an additional burden they don’t need.”

According to the UniSA researchers, visual impairments are frequently neglected in research and clinical settings, with impaired vision being underestimated in up to 50% of older persons.

With this number projected to rise as the population ages, it’s vital that neurodegenerative researchers account for eyesight when assessing people’s cognitive abilities.

“Mobile apps can now be used to overlay simulated visual impairments onto test materials when piloting their stimuli,” the author added.

“Also, researchers can incorporate quick and simple screening tasks before getting people to do cognitive tests. Verbal tasks should always be part of the assessment, too.”

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