Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Abstract

Background: Previous studies evaluating the relationships of glaucoma with Alzheimer's disease (AD) and dementia showed inconsistent results. We performed a meta-analysis of cohort studies to evaluate the association between glaucoma with incidence of AD, all-cause dementia, and non-AD dementia.Methods: Cohort studies which evaluated the association between glaucoma with incidence of AD, all-cause dementia, and non-AD dementia in adult population with multivariate analyses were identified by systematic search of PubMed, Embase, and Cochrane's Library databases. A random-effects model incorporating the potential intra-study heterogeneity was used for the meta-analysis.Results: Eleven cohort studies including 4,645,925 participants were included. Results showed that compared to those without glaucoma at baseline, adult patients with glaucoma was not independently associated with increased incidence of AD [adjusted risk ratio (RR): 1.03, 95% confidence interval (CI): 0.93–1.05, P = 0.55; I2 = 83%], all-cause dementia (adjusted RR: 1.08, 95% CI: 0.97–1.19, P = 0.15; I2 = 79%), or non-AD dementia (adjusted RR: 1.05 95% CI: 0.91–1.21, P = 0.49; I2 = 82%). Sensitivity analyses by excluding one study at a time did not significantly affect the results of the meta-analyses. Moreover, subgroup analyses showed consistent results in meta-analysis of prospective or retrospective cohort studies, and in meta-analysis of patients with primary open-angle glaucoma or primary angle-closure glaucoma (P-values for subgroup difference all > 0.05).Conclusions: Current evidence from cohort studies did not support that glaucoma is an independent risk factor of AD, all-cause dementia, or non-AD dementia in adult population.

The fusiform gyrus exhibits differential gene-gene co-expression in Alzheimer's disease

“…Genetic comorbidity between AD and glaucoma is still unexplored, and consequently, how molecular changes affect both. Recently, Zhao et al ( 2021 ) performed a meta-analysis of cohort studies to evaluate the association between glaucoma and AD. Based on Zhao et al ( 2021 ), the meta-analysis concluded that glaucoma is not an independent risk factor for dementia-related diseases.…”

“…Recently, Zhao et al ( 2021 ) performed a meta-analysis of cohort studies to evaluate the association between glaucoma and AD. Based on Zhao et al ( 2021 ), the meta-analysis concluded that glaucoma is not an independent risk factor for dementia-related diseases. Given the importance of PKN2 in our results, we theorize that AD might play a function in the development of glaucoma disease, however, further studies are needed to support our hypothesis.…”

Efficacy and safety of netarsudil/latanoprost fixed-dose combination vs. monotherapy in open-angle glaucoma or ocular hypertension: A systematic review and meta-analysis of randomized controlled trials

“…For many glaucoma patients, current monotherapy with topical IOP-lowering agents is not sufficiently effective to achieve target IOP ( 21 ). However, most commercially available FDCs for glaucoma, including Cosopt® (timolol-dorzolamide), Combigan® (timolol-brimonidine) and Simbrinza® (brinzolamide-brimonidine), require at least twice-daily dosing, which greatly reduces compliance and adherence to the treatment ( 22 – 24 ).…”

Visual disorders and driving ability in persons with dementia: A mini review

“…An increased occurrence of AMD has been found in patients with AD ( Klaver et al, 1999 ; Nolan et al, 2014 ) and Ab has been also identified in retinal drusen, which are a hallmark of AMD ( Ratnayaka et al, 2015 ). An association of glaucoma and AD is also under investigation ( Ramirez et al, 2017 ; Zhao et al, 2021 ). Two longitudinal studies have shown that poorer visual acuity was often a predictor of higher dementia incidence over time ( Lee et al, 2020 ; Tran et al, 2020 ).…”