Self-reported vision and hallucinations in older adults: results from two longitudinal US health surveys

Background: Vision loss may be a risk factor for hallucinations, but this has not been studied at the population level. Methods: To determine the association between self-reported vision loss and hallucinations in a large community-based sample of older adults, we performed a cross-sectional and longitudinal analysis of two large, nationally representative US health surveys: the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Visual impairment and hallucinations were self- or proxy-reported. Multivariate single and mixed effects logistic regression models were built to examine whether visual impairment and history of cataract surgery were associated with hallucinations. Results: In NHATS (n = 1520), hallucinations were more prevalent in those who reported difficulty reading newspaper print (OR 1.77, 95% confidence interval (CI): 1.32-2.39) or recognising someone across the street (OR 2.48, 95% CI: 1.86-3.31) after adjusting for confounders. In HRS (n = 3682), a similar association was observed for overall (OR 1.32, 95% CI: 1.08-1.60), distance (OR 1.61, 95% CI: 1.32-1.96) and near eyesight difficulties (OR 1.52, 95% CI: 1.25-1.85). In neither sample was there a significant association between cataract surgery and hallucinations after adjusting for covariates. Conclusions: Visual dysfunction is associated with increased odds of hallucinations in the older US adult population. This suggests that the prevention and treatment of vision loss may potentially reduce the prevalence of hallucinations in older adults.