The aim of this project is to explore whether vision correction can effectively slow cognitive decline in older adults.

The primary question it seeks to answer is: Can providing free near and/or distance vision correction glasses to older adults with refractive errors or uncorrected vision, who have normal baseline cognition and hearing, reduce the rate of cognitive decline over 36 months in a cost-effective manner? Researchers will compare the rate of cognitive decline over 36 months between older adults who receive refractive correction and those who do not.

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] < 6/12 in the better-seeing eye and improving to ≥ 6/7.5 or better in either eye with spectacle correction) and/or near VI (presenting near VA < 6/12 at 40 cm when measured binocularly and improving to ≥ 6/7.5 or better in either eye with near correction);
  • 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);