No Increased Risk of Developing Alzheimer Disease in Patients With Glaucoma

Kessing, Lars Vedel; López, Ana García; Andersen, Per Kragh; Kessing, Svend Vedel

doi:10.1097/ijg.0b013e31802b3527

Cited by 101 publications

(114 citation statements)

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“…[15][16][17] In a longitudinal study using nationwide case register data of patients who had been hospitalized in Denmark, Kessing et al 15 found that OAG was not associated with an increased risk of subsequent AD. However, the cases and controls were not matched in terms of sociodemographic characteristics or medical comorbidities, and there may have been a selection bias for patients with more-severe OAG.…”

Section: Discussionmentioning

confidence: 99%

“…12 However, previous epidemiologic studies focusing on the association between OAG and dementia showed inconsistent results. [13][14][15][16][17] There are only four nationwide or population-based studies in Western countries, [15][16][17][18] and, to the best of our knowledge, large epidemiologic investigations regarding the association between OAG and dementia are still lacking in Asian populations. Therefore, the aim of this study was to explore the association between OAG and dementia in an ethnic Chinese (ie, Taiwanese) population by means of a case-control design using a large, nationwide population-based data set in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

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Dementia is associated with open-angle glaucoma: a population-based study

Chung

Chen

et al. 2015

Eye

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Purpose Previous epidemiologic studies that focused on the association between openangle 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; Po0.01). In addition, female dementia patients were more likely to have had prior OAG than controls (OR: 1.93; 95% CI: 1.35-2.77; Po0.001), 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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dementia is associated with open-angle glaucoma: a population-based study

Chung

Chen

et al. 2015

Eye

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“…By contrast, in a large Danish study, no association was found between POAG and AD. 203 Abnormal tau proteins have also been observed in the retina and optic nerve in AD, FTD, and in glaucoma. 204 There is a decline in the density of optic nerve axons in AD.…”

Section: Optic Nervementioning

confidence: 99%

Oculo‐visual changes and clinical considerations affecting older patients with dementia

Armstrong

Kergoat

2015

Ophthalmic Physiologic Optic

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Purpose Dementia is associated with various alterations of the eye and visual function. Over 60% of cases are attributable to Alzheimer's disease, a significant proportion of the remainder to vascular dementia or dementia with Lewy bodies, while frontotemporal dementia, and Parkinson's disease dementia are less common. This review describes the oculo‐visual problems of these five dementias and the pathological changes which may explain these symptoms. It further discusses clinical considerations to help the clinician care for older patients affected by dementia. Recent findings Visual problems in dementia include loss of visual acuity, defects in colour vision and visual masking tests, changes in pupillary response to mydriatics, defects in fixation and smooth and saccadic eye movements, changes in contrast sensitivity function and visual evoked potentials, and disturbance of complex visual functions such as in reading ability, visuospatial function, and the naming and identification of objects. Pathological changes have also been reported affecting the crystalline lens, retina, optic nerve, and visual cortex. Clinically, issues such as cataract surgery, correcting the refractive error, quality of life, falls, visual impairment and eye care for dementia have been addressed. Summary Many visual changes occur across dementias, are controversial, often based on limited patient numbers, and no single feature can be regarded as diagnostic of any specific dementia. Nevertheless, visual hallucinations may be more characteristic of dementia with Lewy bodies and Parkinson's disease dementia than Alzheimer's disease or frontotemporal dementia. Differences in saccadic eye movement dysfunction may also help to distinguish Alzheimer's disease from frontotemporal dementia and Parkinson's disease dementia from dementia with Lewy bodies. Eye care professionals need to keep informed of the growing literature in vision/dementia, be attentive to signs and symptoms suggestive of cognitive impairment, and be able to adapt their practice and clinical interventions to best serve patients with dementia.

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“…Results were skewed by the largest study, but even when excluded, there was still high heterogeneity. The two largest studies 57,58 in this review showed a protective association between AD and glaucoma, whereas the smaller studies suggested greater risk. Methodology varied; half of the studies evaluated both diseases crosssectionally, 51,53,55,59,60 limiting ability to make conclusions about causality and progression.…”

mentioning

confidence: 97%

How strong is the relationship between glaucoma, the retinal nerve fibre layer, and neurodegenerative diseases such as Alzheimer’s disease and multiple sclerosis?

Jones-Odeh

Hammond

2015

Eye

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Glaucoma is a neurodegenerative disorder with established relationships with ocular structures such as the retinal nerve fibre layer (RNFL) and the ganglion cell layer (GCL). Ocular imaging techniques such as optical coherence tomography (OCT) allow for quantitative measurement of these structures. OCT has been used in the monitoring of glaucoma, as well as investigating other neurodegenerative conditions such as Alzheimer's disease (AD) and multiple sclerosis (MS). In this review, we highlight the association between these disorders and ocular structures (RNFL and GCL), examining their usefulness as biomarkers of neurodegeneration. The average RNFL thickness loss in patients with AD is 11 μm, and 7 μm in MS patients. Most of the studies investigating these changes are cross-sectional. Further longitudinal studies are required to assess sensitivity and specificity of these potential ocular biomarkers to neurodegenerative disease progression. Eye (2015Eye ( ) 29, 1270Eye ( -1284 doi:10.1038/eye.2015; published online 4 September 2015 IntroductionGlaucoma is a neurodegenerative optic neuropathy manifesting with progressive retinal ganglion cell (RGC) and axonal loss, which can result in visual field defects and blindness because of permanent cellular and neuronal damage. Subjective clinical examination of the optic nerve head (ONH) allows for assessment and monitoring of the structural changes associated with glaucoma. However, objective detection of defects in the peripapillary retinal nerve fibre layer (RNFL) by ophthalmoscopy is difficult. The relationship between glaucoma progression and the structural changes observed at the ONH, RGC layer, and RNFL in glaucoma is well established. [1][2][3][4] Early diagnosis and treatment of glaucoma is vital to maintain visual field, as loss of RGCs is irreversible, 5 and even before any detectable visual field defects, there is a substantial loss of RGCs. Morphological abnormalities can develop 3-5 years before any functional loss is detected. 6 Since the introduction of ocular imaging techniques such as optical coherence tomography (OCT), peripapillary RNFL thickness measurements have been used for the detection and monitoring of glaucoma. 7,8 However, the use of OCT has extended beyond RNFL measurements for glaucoma, and has also been used in the investigation of other neurodegenerative disorders such as Alzheimer's disease (AD) 9-11 and multiple sclerosis (MS). [12][13][14] In addition, given the similarities of brain and retinal foetal angiogenesis, 15,16 retinal microvasculature has also been investigated as a biomarker of changes in cerebral vasculature and cognitive decline. [17][18][19] In this review, we examine the relationships between glaucoma, neurodegenerative disease, and cognitive impairment, and the use of RNFL thickness and RGC loss as potential ocular biomarkers for neurodegenerative disorders such as AD and MS. We review the strength of associations between RNFL and RGC and Eye (2015Eye ( ) 29, 1270Eye ( -1284Eye ( © 2015 Macmillan Publis...

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No Increased Risk of Developing Alzheimer Disease in Patients With Glaucoma

Abstract: POAG was not associated with increased risk of developing AD. It cannot be excluded that this negative finding is due to diagnostic misclassification as register data were used.

Cited by 101 publications

References 19 publications

Dementia is associated with open-angle glaucoma: a population-based study

Dementia is associated with open-angle glaucoma: a population-based study

Oculo‐visual changes and clinical considerations affecting older patients with dementia

How strong is the relationship between glaucoma, the retinal nerve fibre layer, and neurodegenerative diseases such as Alzheimer’s disease and multiple sclerosis?

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