{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:15:16Z","timestamp":1793142916202,"version":"4.5.0"},"reference-count":61,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi240769-4\"><jats:title>Importance<\/jats:title><jats:p>Vision and eye conditions are associated with increased risk for Alzheimer disease and related dementias (ADRDs), but the nature of the association and the underlying biological pathways remain unclear. If causal, vision would be an important modifiable risk factor with viable population-level interventions.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240769-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate potentially causal associations between visual acuity, eye conditions (specifically cataracts and myopia), neuroimaging outcomes, and ADRDs.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240769-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>A cohort and 2-sample bidirectional mendelian randomization (MR) study was conducted using UK Biobank participants and summary statistics from previously published genome-wide association studies on cataract, myopia, and AD. The participants included in the analysis were aged 55 to 70 years without dementia at baseline (calendar years 2006 to 2010), underwent genotyping, and reported on eye conditions; a subset completed visual acuity examinations (n\u2009=\u200969 852-71 429) or brain imaging (n\u2009=\u200936\u202f591-36 855). Data were analyzed from August 15, 2022, through November 28, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240769-7\"><jats:title>Exposure<\/jats:title><jats:p>Self-reported cataracts, visual acuity, and myopia measured by refraction error.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240769-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>ADRD, AD, and vascular dementia were identified from electronic medical records. Total and regional brain volumes were determined using magnetic resonance imaging.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240769-9\"><jats:title>Results<\/jats:title><jats:p>The sample included 304\u202f953 participants (mean [SD] age, 62.1 (4.1) years; 163\u202f825 women [53.72%]); 14\u202f295 (4.69%) had cataracts and 2754 (3.86%) had worse than 20\/40 vision. Cataracts (hazard ratio [HR], 1.18; 95% CI, 1.07-1.29) and myopia (HR, 1.35; 95% CI, 1.06-1.70) were associated with a higher hazard of ADRD. In MR analyses to estimate potential causal effects, cataracts were associated with increased risk of vascular dementia (inverse variance-weighted odds ratio [OR], 1.92; 95% CI, 1.26-2.92) but were not associated with increased dementia (OR, 1.21; 95% CI, 0.98-1.50). There were no associations between myopia and dementia. In MR for potential reverse causality, AD was not associated with cataracts (inverse variance\u2013weighted OR, 0.99; 95% CI, 0.96-1.01). Genetic risk for cataracts was associated with smaller total brain (\u03b2\u2009=\u2009\u2212597.43 mm<jats:sup>3<\/jats:sup>; 95% CI, \u22121077.87 to \u2212117.00 mm<jats:sup>3<\/jats:sup>) and gray matter (\u03b2\u2009=\u2009\u2212375.17 mm<jats:sup>3<\/jats:sup>; 95% CI, \u2212680.10 to \u221270.24 mm<jats:sup>3<\/jats:sup>) volumes, but not other brain regions.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240769-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort and MR study of UK Biobank participants, cataracts were associated with increased risk of dementia, especially vascular dementia, and reduced total brain volumes. These findings lend further support to the hypothesis that cataract extraction may reduce the risk for dementia.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.24539","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T15:33:51Z","timestamp":1722353631000},"page":"e2424539","source":"Crossref","is-referenced-by-count":26,"title":["Visual Impairment, Eye Conditions, and Diagnoses of Neurodegeneration and Dementia"],"prefix":"10.1001","volume":"7","author":[{"given":"Erin L.","family":"Ferguson","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Thoma","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter T.","family":"Buto","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"},{"name":"Department of Epidemiology, Boston University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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