Document Type


Publication Date

Winter 1-1-2009


This article has been peer reviewed. It is the authors' final version prior to publication in Alzheimer's and Dementia Volume 5, Issue 1, January 2009, Pages 12-17. The published version is available at . doi:10.1016/j.jalz.2008.06.001. Copyright © Elsevier Inc..


BACKGROUND/METHODS: The objective of this study was to determine whether relinquishing cognitive, physical, and social activities is associated with an increased risk of cognitive decline in patients with age-related macular degeneration (AMD). We conducted a 3-year longitudinal study of 206 nondemented patients with AMD.

RESULTS: Twenty-three subjects (14.4%) declined cognitively. Age, sex, education, decline in visual acuity, and number of dropped activities were associated with cognitive decline; each additional dropped activity increased the risk by 58%. Subjects who relinquished three activities were 3.87 times (95% confidence interval, 1.95-7.76) more likely to become demented than subjects who relinquished no activities; those who relinquished five activities were 9.54 times (95% confidence interval, 3.05-30.43) more likely. A multivariate model demonstrated that number of dropped activities was a powerful predictor of cognitive decline after controlling for relevant risk factors, particularly for subjects younger than 80 years of age.

CONCLUSIONS: Relinquishing valued activities is associated with an increased risk of cognitive decline in older patients with vision loss caused by AMD. These data suggest the importance of promoting optimal cognitive and physical health in patients with AMD and perhaps other chronic diseases.

Figure 1.doc (39 kB)
Figure 1. Flow Chart of Sample and Study Measures

Table 1.doc (46 kB)
Table 1: Bivariate Incidence Density Ratios of Study Measures with Dementia Status at Follow-Up (n = 160)

PubMed ID