Abstract

Background: Dementia is a global public health priority, and visual impairment has been identified as a modifiable risk factor. While cataract surgery improves quality of life in mild cognitive impairment, its impact on the burden of caregivers supporting patients with moderate-to-severe dementia remains underexplored. Objectives: To explore changes in caregiver burden following cataract surgery in older adults with dementia. Methods: This prospective, single-center, observational pilot study included 28 patient–caregiver pairs aged ≥ 75 years with dementia who underwent cataract surgery. Caregiver burden was assessed using the Japanese version of the Zarit Burden Interview (J-ZBI) at baseline and 3 months postoperatively. Patient outcomes included best-corrected visual acuity (logMAR), Mini-Mental State Examination (MMSE), and the Barthel Index (BI). Pre- and postoperative values were compared using paired t-tests, with exploratory analyses to identify factors associated with postoperative burden. Results: Visual acuity significantly improved after surgery (p < 0.001). The retention rate was 84.8%, indicating feasibility of postoperative follow-up. No detectable short-term changes were observed in J-ZBI (p = 0.48), BI (p = 0.15), or MMSE (p = 0.89). In exploratory analyses, higher preoperative burden and younger caregiver age were associated with higher postoperative burden. Conclusions: Cataract surgery significantly improved visual acuity in older adults with moderate-to-severe dementia. However, no detectable short-term changes were observed in caregiver burden, cognitive function, or activities of daily living during the 3-month follow-up period. In exploratory analyses, potentially hypothesis-generating associations were suggested between higher baseline J-ZBI scores, younger caregiver age, and higher postoperative burden. The study nevertheless demonstrated the feasibility of conducting prospective research in this population and provides preliminary data for future studies with larger sample sizes and longer follow-up periods.

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