Associations between Cataract and Cognitive Impairment in a Sample of the United States Population

Abstract Background/Objective: Visual impairment has recently been identified as a key modifiable risk factor for dementia. This study investigates the associations between cognitive impairment with both cataract diagnosis and sociodemographic determinants in a large representative sample of the United States civilian, noninstitutionalized population. Subjects/Methods: This is a Cross-sectional study using data from the 2023 iteration of the National Health Interview Survey (NHIS). Participants of the NHIS were included if they answered key questions regarding cognitive impairment and cataract. The primary outcomes included the associations between cognitive impairment with cataract, controlling for sociodemographic factors and modifiable risk factors for dementia. Associations were modeled through univariable and multivariable logistic regression analysis. Results Overall, 29,522 participants were included in the study, comprising 13,462 males (45.6%) and 16,060 females (54.4%). Of these, 19,781 (67.0%) were under the age of 65, while 9,741 (33.0%) were 65 or older. Univariable analysis showed that there were higher odds of cognitive impairment amongst those with cataract (OR = 2.31, p < 0.001). Multivariable analysis showed significant associations between cognitive impairment with cataract (OR = 1.58, p < 0.001), high cholesterol (OR = 1.49, p = 0.004), depression (OR = 2.75, p < 0.001), history of traumatic brain injury (OR = 1.52, p < 0.001), smoking (OR = 1.16, p < 0.025), social isolation (OR = 4.11, p < 0.001), low levels of physical activity (OR = 1.69, p < 0.001), and hearing impairment (OR = 2.26, p < 0.001). Conclusions Cognitive impairment was robustly associated with cataract in a representative sample of the United States civilian population age 18 and older. Health policymakers should consider the impact of cataract in designing preventative and treatment strategies for individuals with cognitive impairment.