Association of Glaucoma and Cataract with Incident Dementia: A 5-Year Follow-Up in the Shanghai Aging Study

J Alzheimers Dis. 2020;76(2):529-537. doi: 10.3233/JAD-200295.

Abstract

Background: Growing evidence has shown the association between ophthalmic disorders and the risk of cognitive decline, but the conclusions were inconsistent.

Objective: This study aimed to verify the hypothesis that glaucoma or cataract or their combination is associated with incident dementia in Chinese older adults.

Methods: We followed up 1,659 non-demented community residents aged ≥60 years for an average of 5.2 years in the Shanghai Aging Study. Histories of glaucoma and cataract were collected based on self-report and medical record confirmation. Consensus diagnoses of incident dementia and Alzheimer's disease (AD) were made based on neurological and neuropsychological assessments.

Results: During the follow-up, 168 cases (10.1%) of incident dementia and 124 cases (7.5%) of incident AD were identified. Participants with glaucoma at baseline had a significant risk of incident dementia (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.08-5.23) and incident AD (HR = 2.77, 95% CI 1.17-6.56) after adjusting for confounders. There was no association between cataract and incident dementia (HR = 1.23, 95% CI 0.85-1.79) or AD (HR = 1.14, 95% CI 0.73-1.77). Those who had both glaucoma and cataract were more likely to develop dementia (HR = 3.08, 95% CI 1.29-7.37) and AD (HR = 3.72, 95% CI 1.52-9.14), compared to those without ophthalmic conditions.

Conclusion: Glaucoma is an independent risk factor of incident dementia and AD. The comorbidity of glaucoma and cataract may significantly increase the risk of dementia and AD.

Keywords: Alzheimer’s disease; cataract; cohort studies; dementia; glaucoma; ophthalmology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging* / psychology
  • Cataract / diagnosis
  • Cataract / epidemiology*
  • Cataract / psychology
  • China / epidemiology
  • Dementia / diagnosis
  • Dementia / epidemiology*
  • Dementia / psychology
  • Female
  • Follow-Up Studies
  • Glaucoma / diagnosis
  • Glaucoma / epidemiology*
  • Glaucoma / psychology
  • Humans
  • Incidence
  • Life Style
  • Male
  • Middle Aged