Untreated Vision Loss: A Surprising Link to Dementia Prevention

In this post, we review “Untreated Vision Loss as a Modifiable Dementia Risk Factor,” a Viewpoints article written by Joshua Ehrlich, MD for JAMA Ophthalmology (published in November 2024). In recent years, the connection between untreated vision loss and the risk of dementia has emerged as an essential area of research, reshaping how we understand modifiable risk factors for cognitive decline. The 2024 Lancet Commission on Dementia Prevention has placed untreated vision impairment firmly on the map as a factor that significantly increases dementia risk by about 50%. This post explores the profound implications of this discovery and the potential for eye care to shape public health strategies in the years ahead.

The Growing Burden of Dementia

Globally, dementia is a mounting challenge. As of 2019, 55 million people were living with the condition, with associated care costs reaching $1.3 trillion. By 2050, this number is expected to rise to 139 million, nearly tripling costs to $2.8 trillion annually. This escalation underscores the urgent need for preventive measures to lessen its impact.

Dementia prevention efforts historically focused on addressing cardiometabolic factors like physical activity and reducing conditions like diabetes. Now, thanks to groundbreaking work by vision health researchers, visual impairment has joined the ranks of these modifiable risks.

The Unique Role of Vision Impairment

While other well-known dementia risks—such as smoking or hypertension—often require large-scale policy and behavioral interventions, untreated vision loss offers a unique opportunity. Over 75% of global vision impairment is linked to two highly treatable conditions: cataracts and uncorrected refractive errors. Treatment for these conditions is not only clinically effective but also cost-effective, making vision care a promising public health intervention to lower dementia risk.

Bridging Ophthalmology and Cognitive Health

The eye serves as a gateway to the central nervous system, with advanced imaging techniques like fundus photography and optical coherence tomography providing potential biomarkers for systemic conditions such as dementia. Exploring these relationships further could revolutionize early detection and intervention strategies.

Looking Ahead

To truly unlock the potential of vision care in dementia prevention, additional clinical trials are necessary to solidify the evidence base and inform public policy. Vision health must become a cornerstone of discussions about healthy aging.

Moreover, collaborations among gerontologists, ophthalmologists, neurologists, and policymakers can ensure eye care remains central to public health frameworks. As new avenues in research emerge, improving access to vision treatments will not only benefit individuals but also bolster community health and economic resilience.