Association of Glaucoma and Cataract with Incident Dementia: A 5-Year Follow-Up in the Shanghai Aging Study
Zhenxu Xiao, Wanqing Wu, Qianhua Zhao, Xiaoniu Liang, Jianfeng Luo, Ding Ding
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.