# Vision and hallucinations in older adults

> **NIH NIH K23** · UNIVERSITY OF PENNSYLVANIA · 2024 · $234,249

## Abstract

PROJECT SUMMARY
Visual hallucinations affect approximately 20% of Alzheimer disease and 50% of all Parkinson disease
patients. Hallucinations are a leading source of patient and caregiver distress and are an independent risk
factor for injury, nursing home placement, and mortality. Because treatment options for hallucinations are
limited and have significant adverse effect risks, the prevention of hallucinations would have a transformative
public health impact for older adults with neurodegenerative disease. Visual impairment is a risk factor for
hallucinations, and since up to half of all vision loss in the U.S. is preventable or treatable, the prevention and
treatment of ophthalmic disease could prevent or reduce the severity of hallucinations in older adults. However,
studies of specific age-related eye diseases and hallucination outcomes are lacking, limiting these
improvements in healthcare. This proposal requests support for a mentored career development award for Dr.
Ali Hamedani, a neurology-trained neuro-ophthalmologist and epidemiologist at the University of Pennsylvania.
The overarching goal of this project is to understand how visual pathway structure, function, diseases, and
treatments contribute to hallucinations in older adults. In Aim 1, Dr. Hamedani will analyze longitudinal data
from two Medicare-linked national health surveys (the National Health and Aging Trends Study and Health and
Retirement Study) to determine whether age-related macular degeneration, primary open-angle glaucoma, and
cataract surgery are associated with the incidence of hallucinations in a nationally representative sample of
5,200 high-risk older adults using advanced survival analysis with marginal structural models to account for
time-dependent confounding. In Aim 2, Dr. Hamedani will recruit a prospective cohort of Parkinson disease
patients who are beginning a medication for hallucinations to determine whether low-contrast acuity and retinal
ganglion cell thickness are associated with hallucination severity and treatment response. In executing these
aims, Dr. Hamedani will be obtain additional training in ophthalmic epidemiology, retinal imaging, and
biostatistics under the mentorship of experts in optical coherence tomography and ophthalmic clinical
investigation (Joel Schuman, MD) and neurodegenerative disease epidemiology and health services research
(Allison Willis, MD MSCI). The results of this project will provide fundamental knowledge about the visual
system’s role in causing hallucinations and pave the way for future studies to test visual impairment and
ophthalmic disease as a prevention target for hallucinations and other neurocognitive outcomes in older adults.
Through the research training and mentorship experience gained during this career development award, Dr.
Hamedani will establish himself as an independent investigator in the applied epidemiology and outcomes
research of ophthalmology in aging and neurodegenerative disease.

## Key facts

- **NIH application ID:** 10796933
- **Project number:** 5K23EY033438-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Ali G Hamedani
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $234,249
- **Award type:** 5
- **Project period:** 2022-03-01 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10796933

## Citation

> US National Institutes of Health, RePORTER application 10796933, Vision and hallucinations in older adults (5K23EY033438-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10796933. Licensed CC0.

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