Association of Open-Angle Glaucoma with Non-Alzheimer's Dementia and Cognitive Impairment.

ABSTRACT

PURPOSE: To compare the odds of central neurodegenerative diseases in patients with open-angle glaucoma (OAG) with the odds in patients without glaucoma (control patients). DESIGN: Cross-sectional study. PARTICIPANTS: Patients 18 years of age or older who visited Duke University Health System between January 1, 2000, and July 31, 2015. METHODS: An electronic query of patient records at Duke University Health System was performed to identify patients with and without diagnoses of OAG, amyotrophic lateral sclerosis (ALS), Alzheimer's disease (AD), Parkinson's disease (PD), vascular dementia (VD), senile dementia (SD), mild cognitive impairment (MCI), and other neurodegenerative diseases. Univariate logistic regression analyses were performed to calculate unadjusted odds ratios (OR). Age group, race, and gender were included as covariates in multiple logistic regression analyses to calculate adjusted ORs. MAIN OUTCOME MEASURES: Odds ratios comparing the odds of each neurodegenerative disease in OAG patients with the odds in control patients. RESULTS: A total of 1 511 602 patients were included in this study 24 892 OAG patients and 1 484 790 control patients. Mean age was 58.9 ± 14.0 years for OAG patients and 44.9 ± 14.1 years for control patients. After adjusting for age, race, and gender, the OR comparing the odds of each neurodegenerative disease in OAG patients with the odds in control patients were as follows for AD adjusted OR, 0.84; 95% confidence interval (CI), 0.77-0.93; for ALS adjusted OR, 0.28; 95% CI, 0.14-0.49); for PD adjusted OR, 1.00; 95% CI, 0.89-1.13; for VD adjusted OR, 1.11; 95% CI, 0.99-1.25; for SD adjusted OR, 1.30; 95% CI, 1.19-1.41; for MCI adjusted OR, 2.00; 95% CI, 1.79-2.22; and for other neurodegenerative disease adjusted OR, 1.79; 95% CI, 1.51-2.10. CONCLUSIONS: Open-angle glaucoma patients may have increased odds of SD, MCI, and other neurodegenerative diseases. Further work is necessary to identify potential causal relationships. A negative correlation exists between OAG and ALS diagnosis that is likely related to limited life expectancy and physical limitations in ALS patients. A weak negative correlation exists between OAG and AD diagnosis. No correlation exists between OAG and PD or VD.