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Exploring a Link Between Vision and Dementia

A multi-institutional team of researchers, led by the Mandel School of Applied Social Sciences at Care Western Reserve University, will begin a five-year, $2.9 million National Institutes of Health- funded study. They will examine the lives of patients with both cataracts and Alzheimer’s disease (AD) to document how restored vision improves everyday life for people with dementia.

“This project addresses a major social justice issue in the disparity in vision care of persons diagnosed with Alzheimer’s disease,” said Grover “Cleve” Gilmore, dean of the Case Western Reserve Mandel School and principle investigator of the study.

In 201 years of research, Gilmore has found people with dementia lose their ability to see objects in medium- and low-contrast environments, but boosting the contrast of the objects improves their ability to move around their homes; eat better; read; and do other simple, everyday tasks.

Cataracts cloud and blur the vision in the eye causing AD patients additional problems. If untreated, the cataracts lead to blindness, but sight can be restored with surgery to remove the cataract.

Co-investigator Jonathan Lass, M.D., the Charles I Thomas Professor and chair of the department of ophthalmology and visual sciences at the Case Western Reserve School of Medicine and director of the Eye Institute at University Hospitals, says, surprisingly, a preliminary study has shown 10 percent of patients over 65 who have an eye exam have some memory impairment along with cataracts. Most people start to show signs of cataracts in their early 60’s.

“This research is important because we are a visual world,” said Thomas Steinemann, M.D., professor of ophthalmology at the School of Medicine and ophthalmologist in the ophthalmology division at MetroHealth Medical Center.

Steinemann said he observed improvements in AD patients following cataract surgery. Some who were combative before surgery are more cooperative following it. And even though they still are cognitively impaired to some degree, Steinemann said improved vision may even help AD patients recognize family members.

“Ultimately, if you can’t perceive something, it is hard to remember it,” says Alan Lerner, associate professor of neurology at the Case Western Reserve School of Medicine and director of the Memory and Cognition Center in University Hospital’s Neurological Institute. “If the vision is blurry, then your memory may be more faulty then necessary. The cataract removal may offer benefits of improved quality of life which is a major aim in AD therapeutics overall.”

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