Relationship between retinopathy and cognitive impairment may be confounded by visual impairment

摘要

To the Editor: In the article "Retinopathy and Cognitive Impairment in Adults With CKD" by Yaffe et al, the authors report that participants with retinopathy had an increased likelihood of cognitive impairment on executive function, attention, and naming assessments after multivariable adjustment. We commend the authors on exploring this important topic. However, we question whether the results may be confounded by concurrent changes in lens opacity, visual acuity, or contrast sensitivity in individuals with retinopathy. The 3 cognitive assessments that elicited significant differences between the 2 groups, the Trails A (attention), Trails B (executive function), and Boston Naming Test (naming), are all tasks that require adequate sight to provide a valid measurement of cognitive function.