Cataract Surgery, Visual Function, and Neurocognitive Outcomes in Older Adults: A Prospective Monocentric Study

Cataract Surgery, Visual Function, and Neurocognitive Outcomes in Older Adults: A Prospective Monocentric Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Cataract Surgery, Visual Function, and Neurocognitive Outcomes in Older Adults: A Prospective Monocentric Study Luigia Piro This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8182062/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Age-related cataract is the leading cause of reversible vision loss and sensory deprivation in the elderly. Increasing evidences suggest that visual restoration through cataract surgery may influence cognitive performance, emotional state, and circadian regulation. Methods: This prospective observational study included 81 elderly patients (mean age 78 years, 65% female) undergoing phacoemulsification with monofocal intraocular lens (IOL) implantation. Cognitive and psychological assessments were performed at baseline (T0), one month (T1), and six months (T2) postoperatively using the Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS-15), Perceived Stress Scale (PSS), and Insomnia Severity Index (ISI). Results: Significant improvement in global cognitive performance was observed, with mean MoCA scores increasing from 22.6 at baseline to 25.2 at one month ( p < .001), and stabilising at six months ( p = .661). PSS scores showed a significant reduction ( p = .016), while GDS-15 and ISI demonstrated non-significant but favourable trends. Subdomain analyses revealed significant improvements in visuospatial-executive, attention, abstraction, and delayed recall domains. Regression analyses identified change in best-corrected visual acuity (BCVA), educational level, and absence of neurological comorbidities as independent predictors of cognitive gain ( p < .05). Conclusions: Cataract surgery contributes not only to improved vision, but also to enhanced cognitive function and stress reduction. These findings reinforce the concept that ophthalmic surgery can play a pivotal role in promoting cognitive resilience and psychological well-being among the elderly population worldwide. Health sciences/Diseases/Eye diseases/Lens diseases Health sciences/Medical research/Outcomes research Cataract Phacoemulsification Visual acuity Cognition MoCA Aging Depression Sleep Stress Quality of life Full Text Additional Declarations There is no conflict of interest Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8182062","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":549221267,"identity":"0c7bf3fe-1b94-4439-b508-caa6c540a1d7","order_by":0,"name":"Luigia 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Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cataract, Phacoemulsification, Visual acuity, Cognition, MoCA, Aging, Depression, Sleep, Stress, Quality of life","lastPublishedDoi":"10.21203/rs.3.rs-8182062/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8182062/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003eAge-related cataract is the leading cause of reversible vision loss and sensory deprivation in the elderly. Increasing evidences suggest that visual restoration through cataract surgery may influence cognitive performance, emotional state, and circadian regulation.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eThis prospective observational study included 81 elderly patients (mean age 78 years, 65% female) undergoing phacoemulsification with monofocal intraocular lens (IOL) implantation. Cognitive and psychological assessments were performed at baseline (T0), one month (T1), and six months (T2) postoperatively using the Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS-15), Perceived Stress Scale (PSS), and Insomnia Severity Index (ISI).\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eSignificant improvement in global cognitive performance was observed, with mean MoCA scores increasing from 22.6 at baseline to 25.2 at one month (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), and stabilising at six months (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.661). PSS scores showed a significant reduction (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.016), while GDS-15 and ISI demonstrated non-significant but favourable trends. Subdomain analyses revealed significant improvements in visuospatial-executive, attention, abstraction, and delayed recall domains. Regression analyses identified change in best-corrected visual acuity (BCVA), educational level, and absence of neurological comorbidities as independent predictors of cognitive gain (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05).\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e\u003cp\u003eCataract surgery contributes not only to improved vision, but also to enhanced cognitive function and stress reduction. These findings reinforce the concept that ophthalmic surgery can play a pivotal role in promoting cognitive resilience and psychological well-being among the elderly population worldwide.\u003c/p\u003e","manuscriptTitle":"Cataract Surgery, Visual Function, and Neurocognitive Outcomes in Older Adults: A Prospective Monocentric Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-25 18:06:53","doi":"10.21203/rs.3.rs-8182062/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"add91fda-e30b-428c-b139-4dc6eb724272","owner":[],"postedDate":"November 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":58442054,"name":"Health sciences/Diseases/Eye diseases/Lens diseases"},{"id":58442055,"name":"Health sciences/Medical research/Outcomes research"}],"tags":[],"updatedAt":"2026-02-05T09:05:26+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-25 18:06:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8182062","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8182062","identity":"rs-8182062","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}