Association of Ophthalmic and Systemic Conditions with Dementia Risk

Takeaway

• Ophthalmic conditions, including age-related macular degeneration (AMD), cataract and diabetes-related eye disease (DRED), but not glaucoma, were associated with an increased risk of incident dementia.
• Individuals with both ophthalmic and systemic conditions had a higher risk of dementia compared with those with an ophthalmic or systemic condition alone.

Why this matters

• Findings suggest that older adults with both ophthalmic and systemic conditions should be targeted for the prevention and screening of dementia.

Study design

• The study included 12,364 participants (age, 55-73 years) from the UK Biobank, assessed at baseline between 2006 and 2010 and followed up until early 2021.
• Funding: Fundamental Research Funds of the State Key Laboratory of Ophthalmology and others.

Key results

• Over 1,263,513 person-years of follow-up, 2304 new cases of incident all-cause dementia, 945 new cases of Alzheimer’s disease and 513 new cases of vascular dementia were reported.
• The risk of all-cause dementia increased with (adjusted HR [aHR]; 95% CI):
  • AMD (1.26; 1.05-1.52);
  • cataract (1.11; 1.00-1.24);
  • DRED (1.61; 1.30-2.00); and
• Glaucoma had no significant association with incident all-cause dementia.
• Among combinations of AMD and a systemic condition, AMD and diabetes together were associated with a higher risk of incident dementia (aHR, 2.73; 95% CI, 1.79-4.17).
• The risk of incident dementia increased with:
  • cataract and a comorbidity such as (aHR; 95% CI):
    • stroke (2.00; 1.40-2.84);
    • heart disease (1.77; 1.43-2.21);
    • obesity (1.19; 0.95-1.48);
    • hypertension (1.36; 1.17-1.58);
    • diabetes (2.19; 1.78-2.70);
    • depression (2.29; 1.74-3.01); and
    • any systematic condition (1.57; 1.36-1.81).
  • DRED and a comorbidity such as (aHR; 95% CI):
    • stroke (2.29; 1.18-4.46);
    • heart disease (3.24; 2.18-4.81);
    • obesity (2.29; 1.36-3.84);
    • hypertension (1.50; 1.02-2.21);
    • depression (1.84; 0.85-4.01); and
    • any systematic condition (1.91; 1.16-3.14).

Limitations

• Ophthalmic conditions were defined as per self-reported and inpatient record data, which could lead to misclassification errors.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.