Vision Issues in Patients With Parkinson Disease Linked With Behavioral, Cognitive Impairment

Patients with Parkinson disease (PD) who experience visual impairment were found to be more prone to behavioral issues such as depression and anxiety, as well as dementia and death, according to study findings published in Movement Disorders.

The increased risk of vision and eye issues in patients with PD (PwP) compared with the general population has been highlighted in prior research, with 1 study indicating that 82% of surveyed PwP reported 1 or more ophthalmologic symptoms versus 48% of those without PD.

This distinct risk could prove detrimental to PwP as researchers note that visual impairment in the general population is associated with hip fracture, depression, anxiety, and dementia. Added to the complexity of a movement disorder such as PD, those with vision issues and PD may be at further risk.

Researchers sought to better assess implications of visual impairment among PwP as they note a lack of data on prevalence, outcomes, and health care utilization. They performed a cross-sectional analysis of all Medicare beneficiaries with complete data in 2014 and longitudinal analysis of beneficiaries with PD from 2010 to 2014.

In the study, researchers compared the prevalence of visual impairment using logistic regression and examined visual impairment and incident hip fracture, depression, anxiety, dementia, and death via Cox proportional hazards regression.

After evaluating a total of 26,209,997 Medicare beneficiaries in 2014, they found that visual impairment was significantly more prevalent among PwP (1.7%) than those without the condition (0.71%) (adjusted odds ratio = 1.60; 95% CI, 1.56-1.65).

In PwP with reported visual impairment, significantly increased hazard ratios (HR) were exhibited with depression (HR = 1.23; 95% CI, 1.14-1.32), anxiety (HR = 1.34; 95% CI, 1.24-1.43), dementia (HR = 1.28; 95% CI, 1.21-1.36), and death (HR = 1.49; 95% CI, 1.44-1.55).

As less than 60% of Medicare beneficiaries with PD (n = 542,224) were shown in the study to have a yearly eye exam, further investigation is still warranted to examine the full scope of negative PD-related outcomes. “Understanding the mechanisms for these relationships is important for guiding future interventions to improve health outcomes in PD,” concluded the study authors.

Reference

Hamedani AG, Abraham DS, Maguire MG, et al. Visual impairment is more common in Parkinson disease and is a risk factor for poor health outcomes. Mov Disord. Published online July 14, 2020. doi:10.1002/mds.28182