When was the last time you attended an eye test? Was it due to having symptoms you were concerned about, or for a routine check-up? Would your attendance for eye checks alter if you knew that untreated vision loss is now thought to be a potentially modifiable risk factor for dementia?
The Lancet Dementia Prevention Intervention and Care report introduced untreated vision loss as a potentially modifiable risk factor for the first time in their 2024 report. Unlike advancing age, vision impairment is often treatable; making early intervention especially significant.
How vision loss may contribute to dementia
The relationship between vision loss and dementia is complex and not fully understood, but several mechanisms have been suggested as potentially playing a role. Some theories include:
Reduced Cognitive Stimulation
Vision provides the brain with a constant stream of information. When sight deteriorates, the brain receives less sensory input; could this potentially be the cause for accelerating cognitive decline? Activities that help keep the brain active (reading, driving, hobbies, social engagement) often become more difficult with impaired vision.
Over time, could reduced stimulation contribute to changes in memory, attention, and processing speed?
Increased Social Isolation
People with vision impairment are potentially more likely to withdraw socially. Difficulty recognising faces, navigating unfamiliar environments, or participating in conversations may cause reduced confidence and independence.
Social isolation is a recognised risk factor for dementia. Vision loss may therefore indirectly increase dementia risk by limiting meaningful social interaction.
Shared Underlying Disease Processes
Some researchers believe vision loss and dementia may share common vascular or neurodegenerative pathways. Conditions such as diabetes, hypertension, and cardiovascular disease can affect both eye health and brain health simultaneously.
Is dementia risk related to type of vision loss?
The Lancet looked into whether different eye conditions were associated with increased risk.
They found cataracts and diabetic retinopathy were associated with an increased dementia risk, but glaucoma and age-related macular degeneration were not associated with an increased dementia risk.
Learnings
The good news is that many causes of vision loss are treatable, so getting your eyes checked and treating any correctable problem may help protect independence and overall brain health as increasing evidence shows treated vision loss can reduce this potentially modifiable risk.
Many people develop cataracts as we get older, but we can have surgery to remove them. This surgery involves replacing your lens with a new, clear one.
Research suggests that people who have cataracts removed are significantly less likely to develop dementia compared to people who have not. This highlights the importance of seeking an eye test early if you are worried you may have cataracts.
A routine eye test can identify not only refractive errors but for some people can identify wider health conditions such as diabetes and hypertension (high blood pressure); both linked to dementia risk.
Being aware that untreated vision loss is a modifiable risk factor for dementia means individuals, families, clinicians, and policymakers alike, have an opportunity to complete an important shift in thinking; one that recognises eye health as an essential part of healthy ageing and cognitive resilience.
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