Nearly one fifth of adults with vision impairment also report cognitive decline, according to reporting from the Centers For Disease Control (CDC). Research conducted over three years shows that 18% of those with impaired vision had self-reported cognitive decline-related functional limitations. That’s compared with only 4% of those without vision impairment, the research says.

The CDC collected data from 208,601 subjects as part of its Behavioral Risk Factor Surveillance System surveys between 2015 and 2017. Those who said they experienced cognitive decline were asked two follow-up questions: (1) “During the past 12 months, as a result of confusion or memory loss, how often have you given up day-to-day household activities or chores you used to do, such as cooking, cleaning, taking medications, driving or paying bills?” and (2) “During the past 12 months, how often has confusion or memory loss interfered with your ability to work, volunteer or engage in social activities outside the home?”

Those who responded “always,” “usually” or “sometimes” to either question were classified as having functional limitations. Vision impairment was defined as a yes response to the question “Are you blind or do you have serious difficulty seeing, even when wearing glasses?”

“Vision impairment is an important, growing public health concern in the United States,” the report concludes. “Adults with vision impairment might have higher levels of difficulties with activities of daily living.”