Abstract
Purpose
Previous epidemiologic studies that focused on the association between open-angle glaucoma (OAG) and dementia showed inconsistent results. In the present study, we explored the association between OAG and dementia in an ethnic Chinese (ie, Taiwanese) population using a population-based data set.
Methods
We retrieved data on study subjects for this case-control study from the Longitudinal Health Insurance Database 2000. We identified 7770 patients who had a diagnosis of dementia as cases, and 7770 subjects matched in terms of sex and age, which were randomly extracted as controls. A conditional logistic regression conditioned on age group, sex, and index year was used to assess the association of dementia with previously diagnosed OAG among the sampled patients.
Results
Of 15 540 patients, 1.70% had prior OAG, including 2.02% of the dementia group and 1.38% of the controls. After adjusting for patient socioeconomic characteristics and comorbid medical disorders, dementia patients were more likely to have had prior OAG than controls (odds ratio (OR): 1.44; 95% confidence interval (CI): 1.12–1.85; P<0.01). In addition, female dementia patients were more likely to have had prior OAG than controls (OR: 1.93; 95% CI: 1.35–2.77; P<0.001), whereas no statistical difference in prior OAG between male dementia patients and controls was found.
Conclusions
Female dementia patients were associated with a higher proportion of prior OAG than were the controls.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP . The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement 2013; 9: 63–75.
Kalaria RN, Maestre GE, Arizaga R, Friedland RP, Galasko D, Hall K et al. Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors. Lancet Neurol 2008; 7: 812–826.
Blennow K, de Leon MJ, Zetterberg H . Alzheimer's disease. Lancet 2006; 368: 387–403.
Foster PJ, Buhrmann R, Quigley HA, Johnson GJ . The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 2002; 86: 238–242.
Quigley HA . Glaucoma. Lancet 2011; 377: 1367–1377.
Quigley HA, Broman AT . The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006; 90: 262–267.
Boland MV, Quigley HA . Risk factors and open-angle glaucoma: concepts and applications. J Glaucoma 2007; 16: 406–418.
Leske MC, Connell AM . Risk factors for open-angle glaucoma: the Barbados Eye study. Arch Ophthalmol 1995; 113: 918–924.
Klein BE, Klein R, Lee KE . Heritability of risk factors for primary open-angle glaucoma: the Beaver Dam Eye study. Invest Ophthalmol Vis Sci 2004; 45: 59–62.
Kipfer-Kauer A, McKinnon SJ, Frueh BE, Goldblum D . Distribution of amyloid precursor protein and amyloid-beta in ocular hypertensive C57BL/6 mouse eyes. Curr Eye Res 2010; 35: 828–834.
Yoneda S, Hara H, Hirata A, Fukushima M, Inomata Y, Tanihara H . Vitreous fluid levels of beta-amyloid((1–42)) and tau in patients with retinal diseases. Jpn J Ophthalmol 2005; 49: 106–108.
McKinnon SJ . Glaucoma: ocular Alzheimer’s disease? Front Biosci 2003; 8: s1140–s1156.
Bayer AU, Ferrari F, Erb C . High occurrence rate of glaucoma among patients with Alzheimer’s disease. Eur Neurol 2002; 47: 165–168.
Tamura H, Kawakami H, Kanamoto T, Kato T, Yokoyama T, Sasaki K et al. High frequency of open-angle glaucoma in Japanese patients with Alzheimer’s disease. J Neurol Sci 2006; 246: 79–83.
Kessing LV, Lopez AG, Andersen PK, Kessing SV . No increased risk of developing Alzheimer disease in patients with glaucoma. J Glaucoma 2007; 16: 47–51.
Ou Y, Grossman DS, Lee PP, Sloan FA . Glaucoma, Alzheimer’s disease and other dementia: a longitudinal analysis. Ophthalmic Epidemiol 2012; 19: 285–292.
Helmer C, Malet F, Rougier MB, Schweitzer C, Colin J, Delyfer MN et al. Is there a link between open-angle glaucoma and dementia?: the Three-City–Alienor cohort. Ann Neurol 2013; 74: 171–179.
Ekström C, Kilander L . Pseudoexfoliation and Alzheimer's disease: a population-based 30-year follow-up study. Acta Ophthalmol 2014; 92 (4): 355–358.
Cheng CL, Kao YH, Lin SJ, Lee CH, Lai ML . Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf 2011; 20: 236–242.
Hsieh C-Y, Chen C-H, Li C-Y, Lai M-L . Validating the diagnosis of acute ischemic stroke in a National Health Insurance claims database. J Formos Med Assoc 2013; 114 (3): 254–259.
Kivipelto M, Helkala EL, Laakso MP, Hänninen T, Hallikainen M, Alhainen K et al. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study. BMJ 2001; 322: 1447–1451.
Gorelick PB . Risk factors for vascular dementia and Alzheimer disease. Stroke 2004; 35: 2620–2622.
Mitchell P, Lee AJ, Rochtchina E, Wang JJ . Open-angle glaucoma and systemic hypertension: The Blue Mountains Eye Study. J Glaucoma 2004; 13: 319–326.
Leske MC . Ocular perfusion pressure and glaucoma: clinical trial and epidemiologic findings. Curr Opin Ophthalmol 2009; 20: 73–78.
Guo L, Salt TE, Luong V, Wood N, Cheung W, Maass A et al. Targeting amyloid-β in glaucoma treatment. Proc Natl Acad Sci USA 2007; 104: 13444–13449.
McKinnon SJ, Lehman DM, Kerrigan-Baumrind LA, Merges CA, Pease ME, Kerrigan DF et al. Caspase activation and amyloid precursor protein cleavage in rat ocular hypertension. Invest Ophthalmol Vis Sci 2002; 43: 1077–1087.
Gupta N, Fong J, Ang LC, Yucel YH . Retinal tau pathology in human glaucomas. Can J Ophthalmol 2008; 43: 53–60.
Silverberg G, Mayo M, Saul T, Fellmann J, McGuire D . Elevated cerebrospinal fluid pressure in patients with Alzheimer’s disease. Cerebrospinal Fluid Res 2006; 3: 7.
Berdahl JP, Allingham RR, Johnson DH . Cerebrospinal fluid pressure is decreased in primary open-angle glaucoma. Ophthalmology 2008; 115: 763–768.
Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K . Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol 2001; 58: 498–504.
Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003; 348: 2508–2516.
Skalicky S, Goldberg I . Depression and quality of life in patients with glaucoma: a cross-sectional analysis using the Geriatric Depression Scale-15, assessment of function related to vision, and the Glaucoma Quality of Life-15. J Glaucoma 2008; 17: 546–551.
Varma R, Lee PP, Goldberg I, Kotak S . An assessment of the health and economic burdens of glaucoma. Am J Ophthalmol 2011; 152: 515–522.
Saczynski JS, Beiser A, Seshadri S, Auerbach S, Wolf PA, Au R . Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology 2010; 75: 35–41.
Vajaranant TS, Nayak S, Wilensky JT, Joslin CE . Gender and glaucoma: what we know and what we need to know. Curr Opin Ophthalmol 2010; 21: 91–99.
Chung SD, Hu CC, Ho JD, Keller JJ, Wang TJ, Lin HC . Open-angle glaucoma and the risk of erectile dysfunction: a population-based case-control study. Ophthalmology 2012; 119: 289–293.
Wang HK, Lin SH, Sung PS, Wu MH, Hung KW, Wang LC et al. Population based study on patients with traumatic brain injury suggests increased risk of dementia. J Neurol Neurosurg Psychiatry 2012; 83: 1080–1085.
Connolly A, Gaehl E, Martin H, Morris J, Purandare N . Underdiagnosis of dementia in primary care: variations in the observed prevalence and comparisons to the expected prevalence. Aging Ment Health 2011; 15 (8): 978–984.
Zhang ZX, Zahner GE, Romn GC, Liu J, Hong Z, Qu QM et al. Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu. Arch Neurol 2005; 62: 447–453.
Xu L, Chen JH, Li JJ, Luo L, Yang H, Zhang RX et al. [The prevalence and its screening methods of primary open angle glaucoma in defined population-based study of rural and urban in Beijing]. Zhonghua Yan Ke Za Zhi 2004; 40: 726–732.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Chung, SD., Ho, JD., Chen, CH. et al. Dementia is associated with open-angle glaucoma: a population-based study. Eye 29, 1340–1346 (2015). https://doi.org/10.1038/eye.2015.120
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2015.120
This article is cited by
-
Prevalence of visual impairment in older people living with dementia and its impact: a scoping review
BMC Geriatrics (2023)
-
Frequency of coexistent eye diseases and cognitive impairment or dementia: a systematic review and meta-analysis
Eye (2023)
-
Cognitive evaluation of patients with glaucoma and its comparison with individuals with Alzheimer’s disease
International Ophthalmology (2018)