Giving prescription glasses to improve vision and thinking in rural older adults

The Impact of Spectacle Intervention for Refractive Error and Presbyopia on Cognitive Function in Rural Older Adults

This project will test whether giving free prescription glasses to rural adults aged 60–79 with correctable vision problems can slow thinking and memory decline over 36 months.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 964 (estimated)
• Ages: 60 Years to 79 Years
• Sex: All
• Sponsor: Sichuan University (Academic / other)
• Locations: 1 site (Ya'an, Sichuan)
• Trial ID: NCT06836440 on ClinicalTrials.gov

What this trial studies

This interventional project provides free prescription near and/or distance glasses to eligible rural older adults and compares their cognitive change over 36 months with a comparison group that does not receive refractive correction. Eligible participants are community-dwelling residents aged 60–79 in Ya'an, Sichuan, who have correctable vision impairment and normal baseline cognition and hearing by C-MMSE cutoffs. Cognitive decline rates will be measured repeatedly over 36 months and the analysis will include cost-effectiveness of the glasses intervention. The work is delivered through local community health service centers and focuses on scalable, low-cost vision correction.

Who should consider this trial

Good fit: Ideal candidates are rural residents aged 60–79 with distance and/or near vision that improves to normal with spectacles, intact baseline cognition and hearing per C-MMSE cutoffs, and who plan to remain in the local area for the study period.

Not a fit: Patients with uncorrectable eye disease, existing cognitive impairment beyond the C-MMSE cutoffs, severe hearing loss, or who cannot use spectacles are unlikely to benefit from this intervention.

Why it matters

Potential benefit: If successful, providing affordable, correctable vision correction could slow cognitive decline and offer a low-cost, widely scalable benefit for older adults.

How similar studies have performed: Observational studies have linked better eyesight to improved cognitive test performance, but there are few long-term randomized or interventional trials showing definitive cognitive slowing from vision correction.

Eligibility criteria

Inclusion Criteria:

* Older adults who meet all of the following criteria will be eligible to participate in this study:

  * Registered as a rural resident (holding rural household registration);
  * Age from 60 to 79 years at the time of enumeration;
  * Resident in the household for \> = 3 months and planning to reside in the local area for the trial duration;
  * Distance vision impairment (VI, presenting visual acuity \[VA\] \< 6/18 in the better-seeing eye and improving to \> = 6/18 with spectacles) and/or near VI (presenting near vision \< N6 at 40 cm and improving to \> = N6 with spectacles);
  * Independent mobility with or without the support of a walking stick;
  * Chinese version of the Mini-Mental State Examination (C-MMSE) score above the following cut-offs (out of 30): \>17 for illiterate participants, \>20 for those with primary school education, \>22 for those with junior high school education, and \>23 for those with high school education or above.
  * Willingness to participate, to be randomized to either study group, and to adhere to the protocol

Exclusion Criteria:

* Presence of glaucoma or visually significant cataract, or a history of surgical treatment for these or other major ocular conditions;
* Consistent use of prescription spectacles and/or hearing aids;
* Serious medical illness likely to result in loss to follow-up. Those less severely affected by conditions such as hypertension and/or diabetes will be eligible;
* Failure on the whispered voice hearing screening test in the better ear (unable to repeat \> = 3 out of 6 words whispered from behind the participant at a distance of 50 cm);

Where this trial is running

Ya'an, Sichuan

• Community health service centers — Ya'an, Sichuan, China (Recruiting)

Study contacts

• Study coordinator: Yuju Wu

Conditions Cognition Disorders