Abstract：
The purpose of this study is to examine the association between blepharoptosis and cognitive performance in late adolescence. This population-based, retrospective, cross-sectional study included 1,411,570 Israeli-born adolescents (620,107 women, 43.9%) aged 16-19 years who were medically examined before compulsory military service between 1993 and 2017. The diagnosis of blepharoptosis was verified by an ophthalmologist. Cognitive performance was assessed by a validated intelligence-quotient-equivalent test, comprising four domains (problem-solving, verbal abstraction and categorization, verbal comprehension, and mathematical abilities). Cognitive Z-scores were calculated and categorized as high (≥ 1 standard deviation (SD)), medium (- 1 to < 1 SD), and low (less than - 1 SD). Relationships were analyzed using regression models adjusted for sociodemographic variables including sex, year of birth, residential socioeconomic status, education level, body mass index, and familial country of origin. A total of 577 (41 per 100,000, 32.2% women) adolescents were diagnosed with blepharoptosis. The proportions of unilateral and bilateral visual impairment among adolescents with blepharoptosis were 13.0% and 3.5%, respectively. In a multivariable analysis, blepharoptosis was associated with a 0.18 SD reduction in cognitive Z-score (p < 0.001). The adjusted odds ratios for low and high cognitive Z-scores in adolescents with blepharoptosis were 1.54 (1.25-1.89) and 0.80 (0.62-1.04), respectively. This relationship persisted when adolescents with normal best-corrected visual acuity or unimpaired health status were analyzed separately. Conclusions: Blepharoptosis is associated with reduced cognitive performance determined in late adolescence. Future prospective studies should investigate the causes of this link and their underlying mechanisms. What is Known: • While earlier investigations have examined the effects of blepharoptosis on vision and quality of life, the association between blepharoptosis and cognitive outcomes in youth has remained unexplored. What is New: • This nationwide study involving 1.4 million Israeli adolescents found a correlation between blepharoptosis and reduced cognitive performance. • Our findings suggest a potential interplay between blepharoptosis and cognitive development in the pediatric population, calling for increased focus on the educational needs of affected individuals.
摘要：
这项研究的目的是研究青春期后期上睑下垂与认知能力之间的关系。这种以人口为基础的，回顾性,横断面研究包括1,411,570名以色列出生的青少年(620,107名妇女，43.9%），年龄在16-19岁之间，在1993年至2017年期间服兵役前接受过体检。眼科医生证实了上睑下垂的诊断。认知表现通过经过验证的智商等效测试进行评估，包括四个领域(解决问题，言语抽象和分类，口头理解，和数学能力)。计算认知Z得分并分类为高(≥1个标准差(SD))，中等（-1至<1SD），和低（小于-1SD）。使用回归模型对关系进行分析，调整社会人口统计学变量，包括性别，出生年份,住宅社会经济地位，教育水平,身体质量指数,和家庭原籍国。共有577名（每100,000人中有41名，32.2％的女性）青少年被诊断患有上睑下垂。青少年上睑下垂患者单侧和双侧视力障碍的比例分别为13.0%和3.5%,分别。在多变量分析中，上睑下垂与认知Z评分0.18SD降低相关(p<0.001)。青少年上睑下垂的认知Z得分低和高的调整后比值比分别为1.54（1.25-1.89）和0.80（0.62-1.04），分别。当分别分析具有正常最佳矫正视力或未受损健康状况的青少年时，这种关系仍然存在。结论：上睑下垂与青春期后期认知能力下降有关。未来的前瞻性研究应该调查这种联系的原因及其潜在机制。Whatisknown:•Whileearlyinvestigationshaveexaminedtheeffectsofbleadopolesingonvisionandqualityoflife,青少年眼睑下垂与认知结局之间的关联仍未被研究.这项涉及140万以色列青少年的全国性研究发现，上睑下垂与认知能力下降之间存在相关性。•我们的研究结果表明，在儿科人群中，眼睑下垂和认知发育之间存在潜在的相互作用。呼吁更多地关注受影响个人的教育需求。
