Vision and Cognitive Difficulties From Midlife to Late Life: Findings From the National Health Interview Survey

Objectives To examine whether the association between vision and cognitive difficulties varies by age group. Methods We analyzed pooled data from the 2021–2023 National Health Interview Survey, including 52,582 U.S. adults aged 45 and older. Vision and cognitive difficulties were based on self-reports. Logistic regression with interaction terms assessed age-related differences. Results Vision difficulty was reported by 22.7% of respondents. It was associated with over twice the odds of cognitive difficulty among adults aged 65–84 (adjusted odds ratio (aOR) = 2.2, p < 0.001), stronger in midlife (ages 45–64; interaction aOR = 1.2, p = 0.002), and weaker among those 85+ (interaction aOR = 0.7, p = <0.001). The predicted probabilities show that adults with vision difficulty were consistently more likely to report cognitive difficulty across all age groups, with the relative difference decreasing with age. Discussion Vision difficulty is linked to higher odds of cognitive difficulty, especially in midlife. Early screening and intervention may support cognitive health across the life course.