Associations Between Age-Related Macular Degeneration, Alzheimer Disease, and Dementia

Abstract

IMPORTANCEThe potential association between age-related macular degeneration (AMD) and Alzheimer disease (AD) is uncertain and has implications for understanding disease pathogenesis, referral, and treatments.OBJECTIVES To determine whether individuals admitted to the hospital with AMD were significantly more or less likely to develop AD or dementia in the following years, as well as to assess whether people with AD or dementia were significantly more or less likely to be admitted to the hospital for AMD treatment in the years following diagnosis of dementia.

Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem)

“…This may be because people with dementia may be less likely to attend regular appointments or to notice or report relevant symptoms and they may be more reliant on carers to manage and facilitate appointments. 117 Our study supports the idea that people with dementia often lack candidacy and may be reliant on family carers to facilitate continuity and access. This clearly has implications for people with dementia who live alone or who do not have family support.…”

“…Eleven studies 98,110,117,118,123,129,136,139,145,155,161 compared access to treatment or receipt of services in groups with and without dementia. Ten 98,110,117,118,129,136,139,145,155,161 of the 11 studies found some evidence that people with dementia were less likely to receive the same quality of care or access to services as those without dementia.…”

“…Ten 98,110,117,118,129,136,139,145,155,161 of the 11 studies found some evidence that people with dementia were less likely to receive the same quality of care or access to services as those without dementia. For instance, studies found that people with dementia were less likely to receive monitoring for diabetes-related problems 97,136 and had reduced access to treatment such as intravenous thrombolysis for stroke, 129 surgery for cataracts, 110 treatment for age-related macular degeneration (AMD) 98,117 or services for diabetes. 139,145 More details are provided in Table 4.…”

“…217 Clinicians may be more reluctant to investigate and treat VI in patients with dementia either because of the difficulties in securing patient co-operation or because treatments are considered inappropriate, or difficult to perform, in patients with dementia. 117 Clinicians in our study across the three conditions expressed concerns about compliance, consent and the appropriateness of treatment in older people with dementia, especially for those with multimorbidity or more advanced dementia. For conditions such as VI it would be better to treat people with dementia earlier rather than later and there may be an argument for fast-tracking people with dementia for treatments such as surgery for cataracts.…”

Comorbidity and dementia: a scoping review of the literature

“…For example, cognitive decline may be accelerated in older people with type 2 diabetes [9,10]. Moreover, the presence of dementia may adversely affect and complicate the clinical care of other conditions and be a key factor in how patients' needs are anticipated and specialist and emergency services are used [11,12]. It may also undermine patients' abilities to selfmanage chronic conditions and engage in health maintenance activities [13].…”