The Association between Cataract Surgery and Cognitive Dysfunction in Cataract Patients - A Population-Based Follow- Up in Taiwan

Purpose: Senile cataract and cognitive dysfunction (senile dementia, cognitive impairment and Alzheimer disease) are commonly coexisting. Some ophthalmologists believe that cataract surgery not only can restore health to a patient’s eyes, but also can improve the degenerative state of mind. Since their relationship is not fully understood, this study aims to prospectively investigate the association between cataract surgery and long-term incidence of cognitive dysfunction among older people with senile cataract. Methods: Retrospective Cohort study design. We used the National Health Insurance Research Database of Taiwan to investigate the relationship between cataract surgery and incidence of cognitive dysfunction in patients with cataract between January 2000 and December 2010. A total of 31401 cataract patients were included. There were 11385 patients receiving cataract surgery and 20016 age-, sex-, and cataract-diagnosis-timing matched controls who were linked to the claim data to identify the first occurrence of a primary or secondary diagnosis of cognitive dysfunction (including cognitive impairment, senile dementia, and Alzheimer disease). We used the Kaplan-Meier method to estimate the survival curves of cognitive dysfunction. Cox proportional hazards regression modeling was used to determine the association between patients with cataract who received surgery or not and risk for cognitive dysfunction, adjusting for comorbidities, such as hypertension, diabetic mellitus, hyperlipidemia, dysrhythmia, and coronary artery disease.