{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T01:13:29Z","timestamp":1784855609227,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Korea","award":["NRF-2021R1C1C1007795"],"award-info":[{"award-number":["NRF-2021R1C1C1007795"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: An advanced age and the female sex are widely recognized risk factors for both cataract and dementia. We investigated the effect of cataract surgery on the incidence of dementia in a Korean population aged \u2265 45 years with a previous diagnosis of cataract. Methods: This nationwide cohort study was performed using Korean National Health Insurance Service data collected from 2006 to 2017. A total of 300,327 subjects aged \u2265 45 years with a history of cataract diagnosis but no previous diagnosis of dementia were analyzed. The relationship between cataract surgery and dementia was evaluated, applying a time-varying analysis to evaluate the hazard ratio (HR) and 95% confidence interval (CI) values according to dementia. It was calculated via a multivariable Cox regression model, with adjustments for age, sex, visual acuity (VA), ocular and systemic comorbidities, and social factors (including body mass index, income, smoking, and drinking). Results: In the multivariate analysis, the cataract surgery group showed a marginal difference in dementia development (HR 1.10 [95% CI 1.02\u20131.19]) because both cataract and dementia share common risk factors. However, in the subgroup analysis, men (HR 0.49 [95% CI 0.26\u20130.90]) and patients under 65 years of age (HR 0.88 [95% CI 0.79\u20130.99]) in the group with cataract surgery and good VA showed a significantly lower incidence of dementia. Conclusion: Through visual improvement, together with timely surgical intervention, the procedure can alleviate the risk of dementia in visually impaired patients, especially in younger and male patients.<\/jats:p>","DOI":"10.3390\/jcm12206441","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T06:14:04Z","timestamp":1696918444000},"page":"6441","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Effect of Cataract Surgery on the Risk of Dementia: A Nationwide Cohort Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5508-3024","authenticated-orcid":false,"given":"Chaeyeon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunhae","family":"Shin","sequence":"additional","affiliation":[{"name":"Seoul Nunevit Eye Clinic, Seoul 05551, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3180-4565","authenticated-orcid":false,"given":"Mina","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Data Science, Hanmi Pharmaceutical Co., Ltd., Seoul 05545, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoonjong","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Data Science, Hanmi Pharmaceutical Co., Ltd., Seoul 05545, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Young","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"},{"name":"Renew Seoul Eye Center, Seoul 06615, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Won","family":"Seo","sequence":"additional","affiliation":[{"name":"Alzheimer\u2019s Disease Convergence Research Center, Samsung Medical Center, Seoul 06351, Republic of Korea"},{"name":"Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"},{"name":"Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3152-1274","authenticated-orcid":false,"given":"Hyemin","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul National University, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-7961","authenticated-orcid":false,"given":"Dong Hui","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"},{"name":"Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.3233\/JAD-180141","article-title":"Differences Between Women and Men in Incidence Rates of Dementia and Alzheimer\u2019s Disease","volume":"64","author":"Beam","year":"2018","journal-title":"J. Alzheimers Dis."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Liu, C.C., Li, C.Y., Sun, Y., and Hu, S.C. (2019). Gender and Age Differences and the Trend in the Incidence and Prevalence of Dementia and Alzheimer\u2019s Disease in Taiwan: A 7-Year National Population-Based Study. Biomed. Res. Int., 2019.","DOI":"10.1155\/2019\/5378540"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/S0140-6736(17)30544-5","article-title":"Cataracts","volume":"390","author":"Liu","year":"2017","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1136\/bjo.2009.165902","article-title":"Cataract and cognitive impairment: A review of the literature","volume":"95","author":"Jefferis","year":"2011","journal-title":"Br. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.3233\/JAD-210250","article-title":"Visual Impairment, Eye Diseases, and Dementia Risk: A Systematic Review and Meta-Analysis","volume":"83","author":"Littlejohns","year":"2021","journal-title":"J. Alzheimers Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1001\/jamainternmed.2021.6990","article-title":"Association Between Cataract Extraction and Development of Dementia","volume":"182","author":"Lee","year":"2022","journal-title":"JAMA Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1093\/gerona\/glab325","article-title":"Visual Impairment and Risk of Dementia in 2 Population-Based Prospective Cohorts: UK Biobank and EPIC-Norfolk","volume":"77","author":"Littlejohns","year":"2022","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ajo.2021.08.010","article-title":"Visual Impairment and Risk of Dementia: The UK Biobank Study","volume":"235","author":"Zhu","year":"2022","journal-title":"Am. J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1111\/ceo.13754","article-title":"Impact of cataract surgery on depression and cognitive function: Systematic review and meta-analysis","volume":"48","author":"Pellegrini","year":"2020","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1111\/ene.12561","article-title":"Cataract surgery is associated with a reduced risk of dementia: A nationwide population-based cohort study","volume":"22","author":"Yu","year":"2015","journal-title":"Eur. J. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4093\/dmj.2016.40.1.79","article-title":"Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association. Data Analytic Process of a Nationwide Population-Based Study Using National Health Information Database Established by National Health Insurance Service","volume":"40","author":"Lee","year":"2016","journal-title":"Diabetes Metab. J."},{"key":"ref_12","first-page":"e15","article-title":"Cohort Profile: The National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea","volume":"46","author":"Lee","year":"2017","journal-title":"Int. J. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1539\/joh.45.335","article-title":"The new BMI criteria for asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent metabolic syndrome in elder Japanese workers","volume":"45","author":"Anuurad","year":"2003","journal-title":"J. Occup. Health"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Miyata, K., Yoshikawa, T., Morikawa, M., Mine, M., Okamoto, N., Kurumatani, N., and Ogata, N. (2018). Effect of cataract surgery on cognitive function in elderly: Results of Fujiwara-kyo Eye Study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0192677"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1111\/j.1532-5415.2005.00499.x","article-title":"Effect of cataract surgery on cognitive function in older adults","volume":"53","author":"Hall","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e2833","DOI":"10.1097\/MD.0000000000002833","article-title":"Association Between Glaucoma and the Risk of Dementia","volume":"95","author":"Su","year":"2016","journal-title":"Medicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"692911","DOI":"10.3389\/fnagi.2021.692911","article-title":"Association between Diabetic Retinopathy and Cognitive Impairment: A Systematic Review and Meta-Analysis","volume":"13","author":"Cheng","year":"2021","journal-title":"Front. Aging Neurosci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.3906\/sag-1406-135","article-title":"Is Alzheimer disease related to age-related macular degeneration?","volume":"45","author":"Seden","year":"2015","journal-title":"Turk. J. Med. Sci."},{"key":"ref_19","first-page":"1777","article-title":"Comorbidity of dementia and age-related macular degeneration calls for clinical awareness: A meta-analysis","volume":"103","author":"Rong","year":"2019","journal-title":"Br. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.ophtha.2019.03.033","article-title":"Visual Acuity Outcomes after Cataract Surgery: High-Volume versus Low-Volume Surgeons","volume":"126","author":"Cox","year":"2019","journal-title":"Ophthalmology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1159\/000514662","article-title":"Visual Acuity Outcomes after Phacoemulsification in Eyes with Good Visual Acuity before Cataract Surgery","volume":"30","author":"Dervenis","year":"2021","journal-title":"Med. Princ. Pract."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"101150","DOI":"10.1016\/j.preteyeres.2022.101150","article-title":"Secondary outcomes of lens and cataract surgery: More than just \u201cbest-corrected visual acuity\u201d","volume":"95","author":"Hecht","year":"2023","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"70","DOI":"10.5603\/MRJ.2018.0012","article-title":"Cognitive functions in patieCognitive functions in patients after cataract phacoemulsification and implantation of multifocal and monofocal intraocular lnts after cataract phacoemulsification and implantation of multifocal and monofocal intraocular lenses","volume":"3","author":"Danek","year":"2018","journal-title":"Med. Res. J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/20\/6441\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:04:18Z","timestamp":1760130258000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/20\/6441"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,10]]},"references-count":23,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12206441"],"URL":"https:\/\/doi.org\/10.3390\/jcm12206441","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,10]]}}}