Cataract Surgery Might Improve Quality of Life for People with Alzheimer's
Surgery is normally not a good option for people as they get older and can be especially difficult (and disorienting) for people with dementia. Furthermore, researchers have found that surgery also can cause dementia to emerge in a patient. However, what if the surgery has a potential upside – like improving the quality of life not only for the person with dementia, but also for the caregiver? Would you consider it?
That’s an interesting possibility, based on an ongoing clinical trial out of Case Western Reserve University and University Hospitals Case Medical Center. This study’s results, which were released at the Alzheimer’s Association’s International Conference 2014, suggest that cataract surgery actually may slow cognitive decline and even improve the quality of life for people with dementia as well as their caregivers.
First of all, let me offer a quick description about cataracts. This condition involves the clouding of the eye’s lens, thus disrupting vision. Cataracts are common in older people; in fact, most Americans have a cataract or have had surgery to remove them by the age of 80. Cataract surgery is one of the most common operations and is also one of the safest and most effective types of surgery. The operation usually lasts less than one hour and is usually fairly painless. Many people can stay awake during surgery and are given an anesthetic to numb the nerves that are in and around the eye. Some people opt to be put to sleep for a short period of time. Most people who have cataract surgery report having better vision afterward.
Before I get into the study, I’d also like to share some information about other vision changes that people with Alzheimer’s may experience. The Alzheimer’s Association reports that more than 60 percent of individuals who have Alzheimer’s have some decline in visual capacity. These changes can include motion blindness (an inability to sense movement), depth perception (which makes three-dimensional projects appear flat), color perception (especially with colors in blue-violet range) or contrast sensitivity (inability to see the contrast between colors). These changes are above and beyond the issues with cataracts, but I would hazard to guess that the cataracts may exacerbate these vision issues, especially as a person moves further along in developing Alzheimer’s.
Now let’s look at the latest research. The Case Western study involved patients who were recruited from two Ohio dementia and ophthalmology clinics. The participants were divided into two groups. Patients in the first group had surgery immediately following their recruitment to the study. The participants in the second group either had delayed surgery or were refused surgery. The researchers assessed the participants’ vision, cognitive status, mood and ability to complete daily activities at the start of the study and six months after recruitment. An assessment also was done six months after cataract surgery for those patients who had the operation.
The researchers’ analysis of results from 20 surgical and eight non-surgical participants found that those who had surgery had both significantly improved visual acuity and enhanced quality of life. Furthermore, they also experienced a slower decline in their executive function and memory as well as an improvement in behavioral measures. Similar results were not seen in the participants who did not have surgery. Additionally, the caregivers of participants who had cataract surgery reported a lessening of their caregiving burdens following the surgery.
“These preliminary results indicate that improved vision can have a variety of benefits for people with dementia and their loved ones, both visual and non-visual,” said Dr. Alan J. Lerner of Case Western Reserve University, who was the lead researcher. “Our findings need to be verified in a larger study, but they suggest the need to aggressively address dementia co-morbidities such as vision-impairing cataracts, while balancing safety and medical risks. If the results hold up, it will significantly affect how we treat cataracts in individuals with dementia. Other interventions to offset sensory loss – including vision and hearing – may help improve quality of life for people with dementia and their caregivers.”
So what’s the takeaway from this study? I’d personally keep watching for further results. However, I also think it makes sense as a caregiver to take to your loved one’s eye doctor about the surgery if he or she has cataracts and any potential ramifications. I’d especially encourage you to have this conversation if your loved one has mild cognitive impairment or is in the earlier stages of Alzheimer’s.
Primary Sources for This Sharepost:
Alzheimer’s Association. (2014). Report from Alzheimer’s Association International Conference 2014 demonstrates benefits of full healthcare treatment for people with Alzheimer’s and other dementias.
Alzheimer’s Association. (ND). Vision problems associated with Alzheimer’s disease.
National Eye Institute. (2009). Facts about cataract.