mivision article, 30 July 2024
A major study has found that people diagnosed with glaucoma have an increased risk of developing dementia later in life, particularly Alzheimer’s disease and vascular dementia.
The findings, published in Ophthalmology,1 suggest that glaucoma may be an early signal of neurodegenerative processes that can lead to cognitive impairment.
Researchers analysed data from over 3.5 million people in Sweden, including 324,730 diagnosed with glaucoma between 1995–2017 and 3.2 million age- and sex-matched controls without glaucoma. They followed both groups for up to 23 years to identify dementia diagnoses.
The results showed those with any type of glaucoma had a 35% higher risk of Alzheimer’s, 65% higher risk of vascular dementia, and 55% higher risk of all-cause dementia compared to controls without glaucoma. The heightened risks were observed across the major glaucoma subtypes.
Notably, the dementia risks were concentrated among individuals diagnosed with glaucoma at older ages, particularly those who were over 80 when diagnosed. In contrast, no increased dementia risks were seen for those diagnosed with glaucoma before age 60.
The associations were similar for men and women after adjusting for sociodemographic factors and comorbidities like hypertension and diabetes. The large sample size allowed precise risk estimates for different glaucoma and dementia subtypes not feasible in prior smaller studies.
“Our findings suggest that monitoring for early symptoms of dementia, such as changes in cognitive function and memory, should be considered in the follow-up care for patients with glaucoma,” the study authors wrote.
“Early detection and treatment could greatly benefit patients and their families by enabling earlier lifestyle and therapeutic interventions to maintain quality of life for as long as possible.
“Screening for dementia is currently underused, and both ophthalmology and primary care clinics can play a much-needed role.”
Glaucoma and dementia share some pathological features, including damage to neurons and axons, vascular dysregulation, and abnormal protein accumulation. However, the study’s observational nature cannot prove glaucoma causes dementia – only that the two conditions are associated, potentially through shared underlying mechanisms.
Reference
- Crump, C., Sundquist, J., Sieh, W., Sundquist, K., Risk of Alzheimer’s disease and related dementias in persons with glaucoma: A national cohort study, Ophthalmology. 2024;131(3)P302–309. DOI: 10.1016/j.ophtha.2023.10.014.