Association between visual impairment and dementia in older Brazilian adults: findings from the ELSI-Brazil study

OBJECTIVE: To investigate the association between visual impairment (VI)-including self-reported near and distance vision and common ophthalmologic conditions-and dementia in a nationally representative sample of older Brazilian adults. METHODS: This study is a secondary analysis using baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which surveyed 5,249 individuals aged 60 years and older. Dementia was identified using an algorithm based on cognitive and functional performance. Visual status was assessed through self-report, distinguishing near and distance VI, along with self-reported diagnoses of ophthalmologic conditions. Logistic regression models adjusted for sociodemographic, clinical, and lifestyle variables were used. RESULTS: Dementia was identified in 364 participants (6.9%). Distance VI was associated with dementia (adjusted OR: 1.68; 95% CI: 1.56-2.44), and there was a significant linear trend between worse self-reported distance vision and greater odds of dementia (p = 0.003). Neither near VI nor any specific ophthalmologic conditions (cataract with/without surgery, glaucoma, macular degeneration, or diabetic retinopathy) were associated with dementia in the adjusted models. CONCLUSION: In this nationally representative sample, self-reported distance VI was associated with dementia. This finding may indicate both a modifiable risk factor and an early marker of cognitive decline, warranting longitudinal research.