ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1611723
This article is part of the Research TopicFrom Eye to Brain: Clinical and Pathological Implications of Ocular DisordersView all 7 articles
Effects of vision impairment on cognitive function: the bidirectional chain
Provisionally accepted
- 1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin, China
- 2Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, China
- 3Eye Institute and School of Optometry, Tianjin, China
- 4Tianjin Medical University Eye Hospital, Tianjin, China
- 5Tianjin Medical University, Tianjin, Tianjin Municipality, China
- 6The Chinese University of Hong Kong, Shatin, Hong Kong Region, China
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Introduction Vision impairment (VI) and cognitive function have profound impacts on quality of life, but there is still a lack of comprehensive research on the connection between VI and cognitive function. The study was designed to investigate factors influencing cognitive function, analyze the link between VI and cognitive function, and explore how sleep quality and psychological disorders mediate this relationship. Methods The study utilizes survey data from the Health and Retirement Study (HRS) involving 10,884 older adults aged 50 and above in the United States. Pearson correlation analysis was conducted to elucidate the associations between the variables, and the R package bruceR (version 2024.6) was used to analyze multiple mediation effects through model 6. Results VI is positively correlated with sleep quality and psychological disorders, and negatively correlated with cognitive function. Sleep quality is positively correlated with psychological disorders and negatively correlated with cognitive function. Psychological disorders are negatively correlated with cognitive function. All correlations are statistically significant. VI directly impacts cognitive function while also indirectly influencing it through sleep quality, psychological disorders, and the bidirectional mediating chain connecting these factors. Conclusion Sleep quality, psychological disorders, and their bidirectional relationships mediate the effect of VI on cognitive function in aging populations. Through this study, we gain a more profound comprehension of how VI relates to cognitive function. In the future, cognitive enhancement in individuals with VI could be achieved by improving sleep quality, addressing psychological disorders, or integrating assessments of these factors into the evaluation of cognitive function.
Keywords: Health and Retirement Study, sleep quality, Psychological disorders, Vision impairment (VI), Cognitive Function, Chain mediation model
Received: 14 Apr 2025; Accepted: 29 Jul 2025.
Copyright: © 2025 Yu, Zhou, Zhao, Lu and Shao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hanna Lu, The Chinese University of Hong Kong, Shatin, Hong Kong Region, China
Yan Shao, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin, 300384, China
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