Objective To explore the epidemiological associations, potential mechanisms, and intervention strategies between four age-related eye diseases—cataract, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR)—and cognitive impairment in the elderly, thus providing scientific evidence for interdisciplinary comprehensive management.

Methods Relevant articles published from January 1, 2010 to November 2025 were systematically retrieved from CNKI, Wanfang Data, Web of Science, and PubMed databases, and 44 eligible research articles were included for analysis.

Results Patients with cataract had a 78% increased risk of all-cause dementia, which decreased by 36.8% after surgery (with a 60.1% reduction in Alzheimer′s disease risk). Patients with glaucoma had a 57%–89% increased risk of dementia, significantly associated with Alzheimer′s disease (+39% risk) and vascular dementia (+66% risk). The prevalence of cognitive impairment in patients with advanced AMD was 30%–40% higher than that in the general elderly population, and individuals with cognitive impairment had a 42% increased risk of progressing to advanced AMD within 5 years. Cognitive impairment in DR patients was dose-dependent. Regarding interventions, cataract surgery effectively reduced dementia risk, and nutritional regulation, lifestyle optimization, and multidisciplinary collaboration delayed disease progression. Community rehabilitation activities achieved an 82% functional maintenance rate, and county-level medical consortium management reduced severe visual impairment from DR by 40%.

Conclusions Aging-related eye diseases and cognitive impairment have close bidirectional associations. Eye diseases are risk factors for cognitive decline and reflect central neurodegeneration. Early screening, multidisciplinary collaboration, and comprehensive management are crucial for improving physical and mental health outcomes.