Ophthalmic conditions associated with dementia risk: The Cardiovascular Health Study

Alzheimers Dement. 2021 Sep;17(9):1442-1451. doi: 10.1002/alz.12313. Epub 2021 Mar 31.

Abstract

Introduction: Ophthalmic conditions and dementia appear to overlap and may share common pathways, but research has not differentiated dementia subtypes.

Methods: Diagnoses of cataracts, age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma were based on medical histories and International Classification of Diseases, Ninth Revision (ICD-9) codes for 3375 participants from the Cardiovascular Health Study. Dementia, including Alzheimer's disease (AD) and vascular dementia (VaD), was classified using standardized research criteria.

Results: Cataracts were associated with AD (hazard ratio [HR] = 1.34; 95% confidence interval [CI] = 1.01-1.80) and VaD/mixed dementia (HR = 1.41; 95% CI = 1.02-1.95). AMD was associated with AD only (HR = 1.87; 95% CI = 1.13-3.09), whereas DR was associated with VaD/mixed dementia only (HR = 2.63; 95% CI = 1.10-6.27).

Discussion: Differential associations between specific ophthalmic conditions and dementia subtypes may elucidate pathophysiologic pathways. Lack of association between glaucoma and dementia was most surprising from these analyses.

Keywords: Age-related macular degeneration; Alzheimer's disease; Cardiovascular Health Study; Cataracts; Dementia; Diabetic retinopathy; Epidemiology; Glaucoma.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cataract / epidemiology*
  • Dementia / epidemiology*
  • Dementia, Vascular / epidemiology*
  • Diabetic Retinopathy / epidemiology*
  • Eye Diseases / epidemiology
  • Female
  • Humans
  • Macular Degeneration / epidemiology*
  • Magnetic Resonance Imaging
  • Male
  • Risk Factors