Glaucoma tied to increased risk of Alzheimer's, related dementias

Individuals with glaucoma, particular those diagnosed at older ages, are prone to developing Alzheimer’s disease (AD), vascular dementia (VaD), and all-cause dementia (ACD), reports a study.

“Persons with glaucoma may need increased monitoring for dementia to facilitate earlier detection and treatment,” the authors said.

A total of 324,730 persons diagnosed with glaucoma during 1995‒2017 in Sweden and 3,247,300 age- and sex-matched control participants without dementia were included in this cohort study. The authors used Cox regression to calculate hazard ratios (HRs) for AD, VaD, and ACD in individuals with glaucoma versus controls, with adjustments for sociodemographic factors and comorbidities.

Of the participants, 32,339 (10 percent) persons with glaucoma and 226,896 (7 percent) controls had a diagnosis of dementia over 16 million person-years of follow-up.

Individuals with glaucoma showed a higher risk of AD (adjusted [a]HR, 1.39; 95 percent confidence interval [CI], 1.35‒1.43), VaD (aHR, 1.66; 95 percent CI, 1.61‒1.72), and ACD (aHR, 1.57; 95 percent CI, 1.54‒1.59) than controls.

Among glaucoma subtypes, primary open-angle and normal-tension glaucoma both correlated with higher risk for AD (aHR, 1.31; 95 percent CI, 1.27‒1.36 and aHR, 1.28; 95 percent CI, 1.20‒1.36, respectively) and VaD (aHR, 1.61; 95 percent CI, 1.54‒1.68 and aHR, 1.39; 95 percent CI, 1.28‒1.50, respectively). On the other hand, primary angle-closure glaucoma correlated with VaD (aHR, 1.26; 95 percent CI, 1.02‒1.56), but not with AD (aHR, 0.98; 95 percent CI, 0.82‒1.18).

“These findings were similar in men and women,” the authors said. “All risks were highest in persons diagnosed with glaucoma at ages ≥70 years and were not elevated for ages <60 years.”