Purpose: To evaluate the age-related change in contrast sensitivity seen in a middle-aged to elderly Japanese population.Methods: Contrast sensitivity and visual acuity were measured in subjects aged 40 to 79 years randomly recruited from a community in Aichi prefecture near Nagoya, Japan. Contrast sensitivity tests were performed using the Vistech contrast sensitivity test chart (VCTS 6500). The results were statistically analyzed relative to age.Results: A statistically significant decrease in contrast sensitivity was seen with advancing age at each spatial frequency (Cochran-Mantel-Haenszel: P<.001). This trend was detected even when the subjects were limited to only those having a corrected visual acuity of 1.0 or better (Cochran-Mantel-Haenszel: P<.001). Overall, 9.4% of the eyes with good visual acuity had poor contrast sensitivity at a high spatial frequency, while in the 70-79-year-old group, the percentage with poor contrast sensitivity reached 21.1%.Conclusions: The age-related decrease in contrast sensitivity was confirmed at all frequencies in our population, even when adjusted for visual acuity. Our results suggest that contrast sensitivity tests, especially at high frequencies, assess aspects of visual function that cannot be determined in the elderly population from visual acuity tests alone.