Abstract：
OBJECTIVE: To examine relationships between visual function (ie, contrast sensitivity, visual field, color vision, and motion perception) and cognitive impairment, including any definition of \"cognitive impairment,\" mild cognitive impairment, or dementia.
METHODS: Systematic review and meta-analyses.
METHODS: Any settings; participants with (cases) or without (controls) cognitive impairment.
METHODS: We searched 4 databases (to January 2024) and included published studies that compared visual function between cases and controls. Standardized mean differences (SMD) with 95% CIs were calculated where data were available. Data were sufficient for meta-analyses when cases were people with dementia. The Joanna Briggs Institute checklists were used for quality assessment.
RESULTS: Fifty-one studies/69 reports were included. Cross-sectional evidence shows that people with dementia had worse contrast sensitivity function and color vision than controls: measured by contrast sensitivity (log units) on letter charts, SMD -1.22 (95% CI -1.98, -0.47), or at varied spatial frequencies, -0.92 (-1.28, -0.57); and by pseudoisochromatic plates, -1.04 (-1.59, -0.49); color arrangement, -1.30 (-2.31, -0.29); or matching tests, -0.51 (-0.78, -0.24). They also performed more poorly on tests of motion perception, -1.20 (-1.73, -0.67), and visual field: mean deviation, -0.87 (-1.29, -0.46), and pattern standard deviation, -0.69 (-1.24, -0.15). Results were similar when cases were limited to participants with clinically diagnosed Alzheimer disease. Sources of bias included lack of clarity on study populations or settings and definitions of cognitive impairment. The 2 included longitudinal studies with follow-ups of approximately 10 years were of good quality but reported inconsistent results.
CONCLUSIONS: In the lack of longitudinal data, cross-sectional studies indicate that individuals with cognitive impairment have poorer visual function than those with normal cognition. Additional longitudinal data are needed to understand whether poor visual function precedes cognitive impairment and the most relevant aspects of visual function, dementia pathologies, and domains of cognition.
METHODS: Systematic review and meta-analyses.
METHODS: Any settings; participants with (cases) or without (controls) cognitive impairment.
METHODS: We searched 4 databases (to January 2024) and included published studies that compared visual function between cases and controls. Standardized mean differences (SMD) with 95% CIs were calculated where data were available. Data were sufficient for meta-analyses when cases were people with dementia. The Joanna Briggs Institute checklists were used for quality assessment.
RESULTS: Fifty-one studies/69 reports were included. Cross-sectional evidence shows that people with dementia had worse contrast sensitivity function and color vision than controls: measured by contrast sensitivity (log units) on letter charts, SMD -1.22 (95% CI -1.98, -0.47), or at varied spatial frequencies, -0.92 (-1.28, -0.57); and by pseudoisochromatic plates, -1.04 (-1.59, -0.49); color arrangement, -1.30 (-2.31, -0.29); or matching tests, -0.51 (-0.78, -0.24). They also performed more poorly on tests of motion perception, -1.20 (-1.73, -0.67), and visual field: mean deviation, -0.87 (-1.29, -0.46), and pattern standard deviation, -0.69 (-1.24, -0.15). Results were similar when cases were limited to participants with clinically diagnosed Alzheimer disease. Sources of bias included lack of clarity on study populations or settings and definitions of cognitive impairment. The 2 included longitudinal studies with follow-ups of approximately 10 years were of good quality but reported inconsistent results.
CONCLUSIONS: In the lack of longitudinal data, cross-sectional studies indicate that individuals with cognitive impairment have poorer visual function than those with normal cognition. Additional longitudinal data are needed to understand whether poor visual function precedes cognitive impairment and the most relevant aspects of visual function, dementia pathologies, and domains of cognition.
摘要：
目的：检查视觉功能之间的关系（即，对比敏感度,视野,色觉,和运动知觉）和认知障碍，包括任何“认知障碍”的定义，“轻度认知障碍，或痴呆症。
方法：系统评价和荟萃分析。
方法：任何设置；有（病例）或没有（对照）认知障碍的参与者。
方法：我们检索了4个数据库（至2024年1月），并纳入了已发表的比较病例和对照组视觉功能的研究。在数据可用的情况下，计算95%CI的标准化平均差(SMD)。当病例为痴呆症患者时，数据足以进行荟萃分析。JoannaBriggs研究所的清单用于质量评估。
结果：纳入51项研究/69份报告。横断面证据表明，痴呆症患者的对比敏感度功能和色觉比对照组更差：通过字母图上的对比敏感度（对数单位）来测量，SMD-1.22（95%CI-1.98，-0.47），或者在不同的空间频率下，-0.90(-1.21，-0.60)；通过伪等色平板，-1.04（-1.59，-0.49）；颜色排列，-1.30（-2.31，-0.29）；或匹配测试，-0.51（-0.78，-0.24）。他们在运动知觉测试中的表现也较差，-1.20（-1.73，-0.67），和视野：平均偏差，-0.87（-1.29，-0.46），和模式标准偏差，-0.69（-1.24，-0.15）。当病例仅限于临床诊断为阿尔茨海默病的参与者时，结果相似。偏倚的来源包括研究人群或认知障碍的设置和定义缺乏明确性。2项纳入的纵向研究随访约10年，质量良好，但报告结果不一致。
结论：在缺乏纵向数据的情况下，横断面研究表明，认知障碍患者的视觉功能比正常认知者差。需要额外的纵向数据来了解视功能不良是否先于认知障碍和视觉功能的最相关方面，痴呆病理学，和认知领域。
方法：系统评价和荟萃分析。
方法：任何设置；有（病例）或没有（对照）认知障碍的参与者。
方法：我们检索了4个数据库（至2024年1月），并纳入了已发表的比较病例和对照组视觉功能的研究。在数据可用的情况下，计算95%CI的标准化平均差(SMD)。当病例为痴呆症患者时，数据足以进行荟萃分析。JoannaBriggs研究所的清单用于质量评估。
结果：纳入51项研究/69份报告。横断面证据表明，痴呆症患者的对比敏感度功能和色觉比对照组更差：通过字母图上的对比敏感度（对数单位）来测量，SMD-1.22（95%CI-1.98，-0.47），或者在不同的空间频率下，-0.90(-1.21，-0.60)；通过伪等色平板，-1.04（-1.59，-0.49）；颜色排列，-1.30（-2.31，-0.29）；或匹配测试，-0.51（-0.78，-0.24）。他们在运动知觉测试中的表现也较差，-1.20（-1.73，-0.67），和视野：平均偏差，-0.87（-1.29，-0.46），和模式标准偏差，-0.69（-1.24，-0.15）。当病例仅限于临床诊断为阿尔茨海默病的参与者时，结果相似。偏倚的来源包括研究人群或认知障碍的设置和定义缺乏明确性。2项纳入的纵向研究随访约10年，质量良好，但报告结果不一致。
结论：在缺乏纵向数据的情况下，横断面研究表明，认知障碍患者的视觉功能比正常认知者差。需要额外的纵向数据来了解视功能不良是否先于认知障碍和视觉功能的最相关方面，痴呆病理学，和认知领域。
