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Chamard C, Alonso S, Carrière I, Villain M, Arnould L, Debourdeau E, Huguet H, Mura T, Daien V. Dementia and glaucoma: Results from a Nationwide French Study between 2006 and 2018. Acta Ophthalmol 2024; 102:e754-e761. [PMID: 38247022 DOI: 10.1111/aos.16624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024]
Abstract
PURPOSE Glaucoma is the leading cause of irreversible blindness worldwide. The brain and eye share many characteristics, so the eye may provide an easy-access window on brain processes. The aim of the study was to evaluate the link between glaucoma as well as intraocular pressure (IOP)-lowering drops load and all-cause dementia. METHODS This was a nested case-control study based on the French national healthcare database from 1 January 2006 to 31 December 2018in individuals aged ≥60 years. We compared cases of incident all-cause dementia with 1:5 controls matched by date of case diagnosis (index date), age, sex, and income. We set a 5-year exposure to glaucoma period ending 2 years before the index date (lag-time period to avoid protopathic bias). The main outcome was glaucoma defined with hospitalization related to POAG and/or dispensations of IOP-lowering drops. The secondary outcome was the IOP-lowering drops load. RESULTS In total, 4810 incident all-cause dementia and 24 050 matched controls were analysed (median [IQR] age 82 [10] years; 66.6% women). The prevalence of glaucoma was 14.0% in controls and cases. Risk of all-cause dementia was not associated with glaucoma (crude OR, 1.02; 95% CI [0.93-1.11]; p = 0.7; adjusted OR, 0.99; 95% CI [0.91-1.09]; p = 0.9) or IOP-lowering drops load (p = 0.2). CONCLUSION The present study in general population ≥60 years old in France did not find any association between glaucoma and incident all-cause dementia.
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Affiliation(s)
- Chloé Chamard
- Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France
- Institute for Neurosciences of Montpellier, Univ Montpellier, INSERM, Montpellier, France
| | - Sandrine Alonso
- Department of Biostatistics, Epidemiology & Public Health, CHRU Nîmes, University of Montpellier, Nîmes, France
| | - Isabelle Carrière
- Institute for Neurosciences of Montpellier, Univ Montpellier, INSERM, Montpellier, France
| | - Max Villain
- Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France
| | - Louis Arnould
- Department of Ophthalmology, University Hospital, Dijon, France
| | - Eloi Debourdeau
- Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France
| | - Héléna Huguet
- Department of Biostatistics, Epidemiology & Public Health, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Thibault Mura
- Department of Biostatistics, Epidemiology & Public Health, CHRU Nîmes, University of Montpellier, Nîmes, France
| | - Vincent Daien
- Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France
- Institute for Neurosciences of Montpellier, Univ Montpellier, INSERM, Montpellier, France
- The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Karthikeyan SK, McKendrick AM, Pai VH, Kuzhuppilly NIR, Ganeshrao SB. Contrast Discrimination and Global Form Perception in Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma. Invest Ophthalmol Vis Sci 2024; 65:33. [PMID: 38771569 PMCID: PMC11114617 DOI: 10.1167/iovs.65.5.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/03/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose This study explored early (contrast discrimination) and intermediate (global form perception) visual processing in primary subtypes of glaucoma: primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). We aimed to understand early and intermediate visual processing in POAG and PACG, matched for similar visual field defect severity. Methods Early visual processing was measured using a contrast discrimination task described by Porkorny and Smith (1997), and intermediate processing using a global form perception task using glass pattern coherence thresholds. Thresholds were determined centrally and at a single midperipheral location (12.5°) in a quadrant without visual field defects. Controls were tested in corresponding quadrants to individuals with glaucoma. Results Sixty participants (20 POAG, 20 PACG, and 20 age-matched controls), aged 50 to 77 years, were included. Visual field defects were matched between POAG and PACG, with mean deviation values of -6.53 ± 4.46 (range: -1.5 to -16.85) dB and -6.2 ± 4.24 (range: -1.37 to -16.42) dB, respectively. Two-Way ANOVA revealed significant differences in thresholds between the glaucoma groups and the control group for both contrast discrimination and global form perception tasks, with higher thresholds in the glaucoma groups. Post hoc analyses showed no significant contrast discrimination difference between POAG and PACG, but POAG had significantly higher thresholds than PACG for form perception. Conclusions In form perception, POAG showed slightly worse performance than PACG, suggesting that individuals with POAG may experience more severe functional damage than PACG of similar visual field severity.
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Affiliation(s)
- Siddharth K Karthikeyan
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Allison M McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia
- Lions Eye Institute, Nedlands, WA, Australia
- Division of Optometry, School of Allied Health, University of Western Australia, Perth, Australia
| | - Vijaya H Pai
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Neetha I R Kuzhuppilly
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shonraj B Ganeshrao
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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3
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Crump C, Sundquist J, Sieh W, Sundquist K. Risk of Alzheimer's Disease and Related Dementias in Persons with Glaucoma: A National Cohort Study. Ophthalmology 2024; 131:302-309. [PMID: 37839560 DOI: 10.1016/j.ophtha.2023.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023] Open
Abstract
PURPOSE Glaucoma is a heterogeneous group of optic neuropathies that potentially may be associated with other cerebral neurodegenerative processes leading to dementia. However, prior studies have been inconsistent. We examined dementia risks after glaucoma diagnosis in a large population-based cohort. DESIGN National matched cohort study. PARTICIPANTS A total of 324 730 persons diagnosed with glaucoma during 1995-2017 in Sweden and 3 247 300 age- and sex-matched population-based controls without prior dementia. METHODS Cox regression was used to compute hazard ratios (HRs) for Alzheimer's disease (AD), vascular dementia (VaD), and all-cause dementia in persons with glaucoma compared with controls, adjusting for sociodemographic factors and comorbidities. MAIN OUTCOME MEASURES Alzheimer's disease, VaD, and all-cause dementia identified from nationwide inpatient and outpatient diagnoses through 2018. RESULTS In 16 million person-years of follow-up, 32 339 persons (10%) with glaucoma and 226 896 controls (7%) were diagnosed with dementia. Persons with glaucoma had increased risks for AD (adjusted HR, 1.39; 95% confidence interval [CI], 1.35-1.43), VaD (1.66; 1.61-1.72), and all-cause dementia (1.57; 1.54-1.59). Among glaucoma subtypes, both primary open-angle and normal-tension glaucoma were associated with increased risk for AD (adjusted HR, 1.31; 95% CI, 1.27-1.36; and 1.28; 1.20-1.36, respectively) and VaD (1.61; 1.54-1.68; and 1.39; 1.28-1.50, respectively), whereas primary angle-closure glaucoma was associated with VaD (1.26; 1.02-1.56) but not AD (0.98; 0.82-1.18). These findings were similar in men and women. All risks were highest in persons diagnosed with glaucoma at ages ≥ 70 years and were not elevated for ages < 60 years. CONCLUSIONS In this large national cohort, persons with glaucoma had increased risks for AD, VaD, and all-cause dementia, particularly those diagnosed with glaucoma at older ages. Persons with glaucoma may need increased monitoring for dementia to facilitate earlier detection and treatment. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Casey Crump
- Departments of Family and Community Medicine and of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center, Houston, Texas.
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Weiva Sieh
- Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
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4
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Loskutova E, Butler JS, Setti A, O'Brien C, Loughman J. Ability to Process Multisensory Information Is Impaired in Open Angle Glaucoma. J Glaucoma 2024; 33:78-86. [PMID: 37974328 DOI: 10.1097/ijg.0000000000002331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
PRCIS Patients with glaucoma demonstrated deficiencies in their ability to process multisensory information when compared with controls, with those deficiencies being related to glaucoma severity. Impaired multisensory integration (MSI) may affect the quality of life in individuals with glaucoma and may contribute to the increased prevalence of falls and driving safety concerns. Therapeutic possibilities to influence cognition in glaucoma should be explored. PURPOSE Glaucoma is a neurodegenerative disease of the optic nerve that has also been linked to cognitive health decline. This study explored MSI as a function of glaucoma status and severity. METHODS MSI was assessed in 37 participants with open angle glaucoma relative to 18 age-matched healthy controls. The sound-induced flash illusion was used to assess MSI efficiency. Participants were presented with various combinations of simultaneous visual and/or auditory stimuli and were required to indicate the number of visual stimuli observed for each of the 96 total presentations. Central retinal sensitivity was assessed as an indicator of glaucoma severity (MAIA; CenterVue). RESULTS Participants with glaucoma performed with equivalent capacity to healthy controls on unisensory trials ( F1,53 =2.222, P =0.142). Both groups performed equivalently on congruent multisensory trials involving equal numbers of auditory and visual stimuli F1,53 =1.032, P =0.314). For incongruent presentations, that is, 2 beeps and 1 flash stimulus, individuals with glaucoma demonstrated a greater influence of the incongruent beeps when judging the number of flashes, indicating less efficient MSI relative to age-matched controls ( F1,53 =11.45, P <0.002). In addition, MSI performance was positively correlated with retinal sensitivity ( F3,49 =4.042, P <0.025), adjusted R ²=0.15). CONCLUSIONS Individuals with open angle glaucoma exhibited MSI deficiencies that relate to disease severity. The type of deficiencies observed were similar to those observed among older individuals with cognitive impairment and balance issues. Impaired MSI may, therefore, be relevant to the increased prevalence of falls observed among individuals with glaucoma, a concept that merits further investigation.
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Affiliation(s)
- Ekaterina Loskutova
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - John S Butler
- Centre for Eye Research Ireland, School of Mathematical Sciences, Technological University Dublin, Dublin, Ireland
| | - Annalisa Setti
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
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5
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Huh MG, Kim YK, Lee J, Shin YI, Lee YJ, Choe S, Kim DW, Jeong Y, Jeoung JW, Park KH. Relative Risks for Dementia among Individuals with Glaucoma: A Meta-Analysis of Observational Cohort Studies. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:490-500. [PMID: 37899286 PMCID: PMC10721395 DOI: 10.3341/kjo.2023.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/31/2023] Open
Abstract
PURPOSE To investigate the relative risks (RRs) for dementia among individuals with glaucoma. METHODS We conducted a search of PubMed, Web of Science, Scopus, and Cochrane databases for observational cohort studies examining the association between glaucoma and dementia until March 2023. Two authors independently screened all titles and abstracts according to predefined inclusion and exclusion criteria. Pooled RR and 95% confidence intervals (CIs) were generated using random-effect models. RESULTS The meta-analysis included 18 cohort studies conducted in eight countries and involving 4,975,325 individuals. The pooled RR for the association between glaucoma and all-cause dementia was 1.314 (95% CI, 1.099-1.572; I2 = 95%). The pooled RRs for the associations of open-angle glaucoma with Alzheimer dementia and Parkinson disease were 1.287 (95% CI, 1.007-1.646; I2 = 96%) and 1.233 (95% CI, 0.677-2.243; I2 = 73%), respectively. The pooled RRs for the associations of angle-closure glaucoma with all-cause dementia and Alzheimer dementia were 0.978 (95% CI, 0.750-1.277; I2 = 17%) and 0.838 (95% CI, 0.421-1.669; I2 = 16%), respectively. No evidence of publication bias was detected in the Begg-Mazumdar adjusted rank correlation test (p = 0.47). CONCLUSIONS Based on current observational cohort studies, there is evidence supporting that glaucoma is a risk factor for dementia in the adult population.
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Affiliation(s)
- Min Gu Huh
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
- EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul,
Korea
| | - Jaekyoung Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Young In Shin
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Yun Jeong Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon,
Korea
| | - Sooyeon Choe
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon,
Korea
| | - Dai Woo Kim
- Department of Ophthalmology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu,
Korea
| | - Yoon Jeong
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
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6
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Radcliffe NM, Shah M, Samuelson TW. Challenging the "Topical Medications-First" Approach to Glaucoma: A Treatment Paradigm in Evolution. Ophthalmol Ther 2023; 12:2823-2839. [PMID: 37855977 PMCID: PMC10640619 DOI: 10.1007/s40123-023-00831-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023] Open
Abstract
Topical glaucoma medications are effective and safe, but they have numerous well-documented limitations that diminish their long-term utility and sustainability. These limitations can include high rates of nonadherence (with associated glaucoma progression), concerning side effects, inconsistent circadian intraocular pressure (IOP) control, complex dosing regimens, difficulty with self-administration, costs, and decreased quality of life. Despite these limitations, topical medications traditionally have been first-line in the glaucoma treatment algorithm, as no other minimally invasive treatment alternatives existed. In recent years, however, novel interventional therapies-including sustained-release drug-delivery platforms, selective laser trabeculoplasty, and micro-invasive glaucoma surgery procedures-have made it possible to intervene earlier without relying on topical medications. As a result, the topical medication-first treatment approach is being reevaluated in an overall shift toward earlier more proactive interventions.
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Affiliation(s)
- Nathan M Radcliffe
- New York Eye Surgery Center, 1101 Pelham Parkway North, Bronx, NY, 10469, USA.
| | - Manjool Shah
- New York University (NYU) Langone Health, New York, NY, USA
| | - Thomas W Samuelson
- Minnesota Eye Consultants, University of Minnesota, Minneapolis, MN, USA
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7
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Passaro ML, Matarazzo F, Abbadessa G, Pezone A, Porcellini A, Tranfa F, Rinaldi M, Costagliola C. Glaucoma as a Tauopathy-Is It the Missing Piece in the Glaucoma Puzzle? J Clin Med 2023; 12:6900. [PMID: 37959365 PMCID: PMC10650423 DOI: 10.3390/jcm12216900] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Glaucoma is a chronic neurodegenerative disorder affecting the visual system which can result in vision loss and blindness. The pathogenetic mechanisms underlying glaucomatous optic neuropathy are ultimately enigmatic, prompting ongoing investigations into its potential shared pathogenesis with other neurodegenerative neurological disorders. Tauopathies represent a subclass of neurodegenerative diseases characterized by the abnormal deposition of tau protein within the brain and consequent microtubule destabilization. The extended spectrum of tauopathies includes conditions such as frontotemporal dementias, progressive supranuclear palsy, chronic traumatic encephalopathy, and Alzheimer's disease. Notably, recent decades have witnessed emerging documentation of tau inclusion among glaucoma patients, providing substantiation that this ocular disease may similarly manifest features of tauopathies. These studies found that: (i) aggregated tau inclusions are present in the somatodendritic compartment of RGCs in glaucoma patients; (ii) the etiology of the disease may affect tau splicing, phosphorylation, oligomerization, and subcellular localization; and (iii) short interfering RNA against tau, administered intraocularly, significantly decreased retinal tau accumulation and enhanced RGC somas and axon survival, demonstrating a crucial role for tau modifications in ocular hypertension-induced neuronal injury. Here, we examine the most recent evidence surrounding the interplay between tau protein dysregulation and glaucomatous neurodegeneration. We explore the novel perspective of glaucoma as a tau-associated disorder and open avenues for cross-disciplinary collaboration and new treatment strategies.
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Affiliation(s)
- Maria Laura Passaro
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | | | - Gianmarco Abbadessa
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Antonio Pezone
- Department of Biology, University of Naples “Federico II”, 80126 Naples, Italy; (A.P.); (A.P.)
| | - Antonio Porcellini
- Department of Biology, University of Naples “Federico II”, 80126 Naples, Italy; (A.P.); (A.P.)
| | - Fausto Tranfa
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | - Michele Rinaldi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
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8
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Lee C, Shin E, Kim M, Bae Y, Chung TY, Seo SW, Jang H, Lim DH. The Effect of Cataract Surgery on the Risk of Dementia: A Nationwide Cohort Study. J Clin Med 2023; 12:6441. [PMID: 37892580 PMCID: PMC10607014 DOI: 10.3390/jcm12206441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND An advanced age and the female sex are widely recognized risk factors for both cataract and dementia. We investigated the effect of cataract surgery on the incidence of dementia in a Korean population aged ≥ 45 years with a previous diagnosis of cataract. METHODS This nationwide cohort study was performed using Korean National Health Insurance Service data collected from 2006 to 2017. A total of 300,327 subjects aged ≥ 45 years with a history of cataract diagnosis but no previous diagnosis of dementia were analyzed. The relationship between cataract surgery and dementia was evaluated, applying a time-varying analysis to evaluate the hazard ratio (HR) and 95% confidence interval (CI) values according to dementia. It was calculated via a multivariable Cox regression model, with adjustments for age, sex, visual acuity (VA), ocular and systemic comorbidities, and social factors (including body mass index, income, smoking, and drinking). RESULTS In the multivariate analysis, the cataract surgery group showed a marginal difference in dementia development (HR 1.10 [95% CI 1.02-1.19]) because both cataract and dementia share common risk factors. However, in the subgroup analysis, men (HR 0.49 [95% CI 0.26-0.90]) and patients under 65 years of age (HR 0.88 [95% CI 0.79-0.99]) in the group with cataract surgery and good VA showed a significantly lower incidence of dementia. CONCLUSION Through visual improvement, together with timely surgical intervention, the procedure can alleviate the risk of dementia in visually impaired patients, especially in younger and male patients.
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Affiliation(s)
- Chaeyeon Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea; (C.L.); (T.-Y.C.)
| | - Eunhae Shin
- Seoul Nunevit Eye Clinic, Seoul 05551, Republic of Korea;
| | - Mina Kim
- Department of Data Science, Hanmi Pharmaceutical Co., Ltd., Seoul 05545, Republic of Korea; (M.K.); (Y.B.)
| | - Yoonjong Bae
- Department of Data Science, Hanmi Pharmaceutical Co., Ltd., Seoul 05545, Republic of Korea; (M.K.); (Y.B.)
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea; (C.L.); (T.-Y.C.)
- Renew Seoul Eye Center, Seoul 06615, Republic of Korea
| | - Sang Won Seo
- Alzheimer’s Disease Convergence Research Center, Samsung Medical Center, Seoul 06351, Republic of Korea;
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Hyemin Jang
- Department of Neurology, Seoul National University, Seoul 03080, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea; (C.L.); (T.-Y.C.)
- Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
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9
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Xu Y, Phu J, Aung HL, Hesam-Shariati N, Keay L, Tully PJ, Booth A, Anderson CS, Anstey KJ, Peters R. Frequency of coexistent eye diseases and cognitive impairment or dementia: a systematic review and meta-analysis. Eye (Lond) 2023; 37:3128-3136. [PMID: 36922645 PMCID: PMC10564749 DOI: 10.1038/s41433-023-02481-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 01/20/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE We aim to quantify the co-existence of age-related macular degeneration (AMD), glaucoma, or diabetic retinopathy (DR) and cognitive impairment or dementia. METHOD MEDLINE, EMBASE, PsycINFO and CINAHL were searched (to June 2020). Observational studies reporting incidence or prevalence of AMD, glaucoma, or DR in people with cognitive impairment or dementia, and of cognitive impairment or dementia among people with AMD, glaucoma, or DR were included. RESULTS Fifty-six studies (57 reports) were included but marked by heterogeneities in the diagnostic criteria or definitions of the diseases, study design, and case mix. Few studies reported on the incidence. Evidence was sparse but consistent in individuals with mild cognitive impairment where 7.7% glaucoma prevalence was observed. Prevalence of AMD and DR among people with cognitive impairment ranged from 3.9% to 9.4% and from 11.4% to 70.1%, respectively. Prevalence of AMD and glaucoma among people with dementia ranged from 1.4 to 53% and from 0.2% to 25.9%, respectively. Prevalence of DR among people with dementia was 11%. Prevalence of cognitive impairment in people with AMD, glaucoma, and DR ranged from 8.4% to 52.4%, 12.3% to 90.2%, and 3.9% to 77.8%, respectively, and prevalence of dementia in people with AMD, glaucoma and DR ranged from 9.9% to 62.6%, 2.5% to 3.3% and was 12.5%, respectively. CONCLUSIONS Frequency of comorbid eye disease and cognitive impairment or dementia varied considerably. While more population-based estimations of the co-existence are needed, interdisciplinary collaboration might be helpful in the management of these conditions to meet healthcare needs of an ageing population. TRIAL REGISTRATION PROSPERO registration: CRD42020189484.
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Affiliation(s)
- Ying Xu
- Neuroscience Research Australia, Sydney, NSW, Australia.
- School of Psychology, Faculty of Science, UNSW, Sydney, NSW, Australia.
- The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia.
- Faculty of Medicine, UNSW, Sydney, NSW, Australia.
- Ageing Futures Institute, UNSW, Sydney, NSW, Australia.
| | - Jack Phu
- Centre for Eye Health, UNSW, Sydney, NSW, Australia
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Concord Clinical School, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Htein Linn Aung
- Neuroscience Research Australia, Sydney, NSW, Australia
- Faculty of Medicine, UNSW, Sydney, NSW, Australia
| | - Negin Hesam-Shariati
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, Faculty of Science, UNSW, Sydney, NSW, Australia
| | - Lisa Keay
- The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia
- Ageing Futures Institute, UNSW, Sydney, NSW, Australia
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
| | - Phillip J Tully
- School of Psychology, The University of New England, Armidale, NSW, Australia
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Craig S Anderson
- The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia
- Faculty of Medicine, UNSW, Sydney, NSW, Australia
- The George Institute for Global Health, Beijing, P.R. China
- Neurology Department, Royal Prince Alfred Hospital, Sydney Local Area Health District, Sydney, NSW, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, Faculty of Science, UNSW, Sydney, NSW, Australia
- Ageing Futures Institute, UNSW, Sydney, NSW, Australia
| | - Ruth Peters
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, Faculty of Science, UNSW, Sydney, NSW, Australia
- The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia
- Faculty of Medicine, UNSW, Sydney, NSW, Australia
- Ageing Futures Institute, UNSW, Sydney, NSW, Australia
- School of Public Health, Imperial College London, London, UK
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10
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Feng J, Huang C, Liang L, Li C, Wang X, Ma J, Guan X, Jiang B, Huang S, Qin P. The Association Between Eye Disease and Incidence of Dementia: Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:1363-1373.e6. [PMID: 37527793 DOI: 10.1016/j.jamda.2023.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES To better demonstrate the relationship between common eye diseases and the risk of dementia, we conducted a systematic review and meta-analysis of cohort studies to investigate the relationship between common eye diseases and dementia. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Patients with common eye diseases. METHODS We conducted a systematic search of articles published up to August 25, 2022, of online databases including PubMed, EMBASE, and Web of Science. We included cohort studies that evaluated the association of glaucoma, age-related macular degeneration (AMD), diabetic retinopathy (DR), and cataracts with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD). Relative risks (RRs) and 95% CIs were pooled using random effects model, and heterogeneity was assessed by the I2 statistic. Subgroup analysis and sensitivity analysis were also performed. RESULTS In total, 25 studies were included in the meta-analysis, with a total of 11,410,709 participants. Pooled estimates suggested an increased risk of all-cause dementia associated with AMD (RR, 1.29; 95% CI, 1.13-1.48), glaucoma (RR, 1.16; 95% CI, 1.03-1.32), DR (RR, 1.40; 95% CI, 1.21-1.63), and cataract (RR,1.23; 95% CI, 1.09-1.40); an increased risk of AD associated with AMD (RR, 1.27; 95% CI, 1.06-1.52), glaucoma (RR, 1.18; 95% CI, 1.02-1.38), DR (RR, 1.21; 95% CI, 1.04-1.41), and cataracts (RR,1.22; 95% CI, 1.07-1.38). No association was observed between incident VaD and any eye diseases. The results of subgroup analyses were consistent with those in meta-analysis of DR and risk of all-cause dementia. Meta-regressions suggested geographic regions as potential sources of heterogeneity for the association between AMD and all-cause dementia, AMD and AD, glaucoma and dementia, glaucoma, and AD, respectively. CONCLUSIONS AND IMPLICATIONS AMD, glaucoma, DR, and cataract may be associated with an increased risk of all-cause dementia and AD, but not VaD. However, the results should be interpreted cautiously because of the high heterogeneity and unstable findings in some subgroup analyses.
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Affiliation(s)
- Jiayi Feng
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China; College of Medicine, Shantou University, Shantou, Guangdong, China
| | - Cuihong Huang
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China; Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lei Liang
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Chuang Li
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China; College of Medicine, Shantou University, Shantou, Guangdong, China
| | - Xiaojie Wang
- Department of Neurology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Jianping Ma
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Xinhui Guan
- Ophthalmology Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Bin Jiang
- Department of Neurology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Shaofen Huang
- Department of Public Health, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Pei Qin
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China.
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11
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Diaz-Torres S, He W, Thorp J, Seddighi S, Mullany S, Hammond CJ, Hysi PG, Pasquale LR, Khawaja AP, Hewitt AW, Craig JE, Mackey DA, Wiggs JL, van Duijn C, Lupton MK, Ong JS, MacGregor S, Gharahkhani P. Disentangling the genetic overlap and causal relationships between primary open-angle glaucoma, brain morphology and four major neurodegenerative disorders. EBioMedicine 2023; 92:104615. [PMID: 37201334 PMCID: PMC10206164 DOI: 10.1016/j.ebiom.2023.104615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/21/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Primary open-angle glaucoma (POAG) is an optic neuropathy characterized by progressive degeneration of the optic nerve that leads to irreversible visual impairment. Multiple epidemiological studies suggest an association between POAG and major neurodegenerative disorders (Alzheimer's disease, amyotrophic lateral sclerosis, frontotemporal dementia, and Parkinson's disease). However, the nature of the overlap between neurodegenerative disorders, brain morphology and glaucoma remains inconclusive. METHOD In this study, we performed a comprehensive assessment of the genetic and causal relationship between POAG and neurodegenerative disorders, leveraging genome-wide association data from studies of magnetic resonance imaging of the brain, POAG, and four major neurodegenerative disorders. FINDINGS This study found a genetic overlap and causal relationship between POAG and its related phenotypes (i.e., intraocular pressure and optic nerve morphology traits) and brain morphology in 19 regions. We also identified 11 loci with a significant local genetic correlation and a high probability of sharing the same causal variant between neurodegenerative disorders and POAG or its related phenotypes. Of interest, a region on chromosome 17 corresponding to MAPT, a well-known risk locus for Alzheimer's and Parkinson's disease, was shared between POAG, optic nerve degeneration traits, and Alzheimer's and Parkinson's diseases. Despite these local genetic overlaps, we did not identify strong evidence of a causal association between these neurodegenerative disorders and glaucoma. INTERPRETATION Our findings indicate a distinctive and likely independent neurodegenerative process for POAG involving several brain regions although several POAG or optic nerve degeneration risk loci are shared with neurodegenerative disorders, consistent with a pleiotropic effect rather than a causal relationship between these traits. FUNDING PG was supported by an NHMRC Investigator Grant (#1173390), SM by an NHMRC Senior Research Fellowship and an NHMRC Program Grant (APP1150144), DM by an NHMRC Fellowship, LP is funded by the NEIEY015473 and EY032559 grants, SS is supported by an NIH-Oxford Cambridge Fellowship and NIH T32 grant (GM136577), APK is supported by a UK Research and Innovation Future Leaders Fellowship, an Alcon Research Institute Young Investigator Award and a Lister Institute for Preventive Medicine Award.
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Affiliation(s)
- Santiago Diaz-Torres
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia.
| | - Weixiong He
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jackson Thorp
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Sahba Seddighi
- Nuffield Department of Population Health, Oxford University, Oxford, UK; Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Christopher J Hammond
- Departments of Ophthalmology & Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Pirro G Hysi
- Departments of Ophthalmology & Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Australia
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, 02114, MA, USA
| | | | - Michelle K Lupton
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jue-Sheng Ong
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Stuart MacGregor
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia
| | - Puya Gharahkhani
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia; School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, Australia.
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12
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Kuang G, Salowe R, O’Brien J. Genetic Factors Implicated in the Investigation of Possible Connections between Alzheimer's Disease and Primary Open Angle Glaucoma. Genes (Basel) 2023; 14:338. [PMID: 36833265 PMCID: PMC9957421 DOI: 10.3390/genes14020338] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
Both Alzheimer's disease (AD) and primary open angle glaucoma (POAG) are diseases of primary global neurodegeneration with complex pathophysiologies. Throughout the published literature, researchers have highlighted similarities associated with various aspects of both diseases. In light of the increasing number of findings reporting resemblance between the two neurodegenerative processes, scientists have grown interested in possible underlying connections between AD and POAG. In the search for explanations to fundamental mechanisms, a multitude of genes have been studied in each condition, with overlap in the genes of interest between AD and POAG. Greater understanding of genetic factors can drive the research process of identifying relationships and elucidating common pathways of disease. These connections can then be utilized to advance research as well as to generate new clinical applications. Notably, AD and glaucoma are currently diseases with irreversible consequences that often lack effective therapies. An established genetic connection between AD and POAG would serve as the basis for development of gene or pathway targeted strategies relevant to both diseases. Such a clinical application could be of immense benefit to researchers, clinicians, and patients alike. This paper aims to summarize the genetic associations between AD and POAG, describe common underlying mechanisms, discuss potential areas of application, and organize the findings in a review.
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Affiliation(s)
| | | | - Joan O’Brien
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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13
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Singh A, Kumar T, Velagala VR, Thakre S, Joshi A. The Actions of Lithium on Glaucoma and Other Senile Neurodegenerative Diseases Through GSK-3 Inhibition: A Narrative Review. Cureus 2022; 14:e28265. [PMID: 36158406 PMCID: PMC9491486 DOI: 10.7759/cureus.28265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/22/2022] [Indexed: 11/27/2022] Open
Abstract
Glaucoma can be described as a set of progressive optic neuropathies. They cause a gradual, irreversible loss of the field of view, which concludes in complete blindness. Evidence suggests that patients who have glaucoma face a greater risk of suffering from senile dementia. Dementia is a group of conditions that occur in old age individuals. Neurodegeneration is a characteristic pathological feature of dementia, the progression of which causes a decline in cognition, which may be accompanied by memory loss. Severe dementia in old individuals usually presents as Alzheimer’s disease, which significantly contributes to a load of dementia in India. Parkinsonism is another common neurodegenerative disease that is known to occur in the elderly. The WNT (Wingless-related integration site)/β-catenin pathway is a multistep process that is responsible for the regulation of various cellular functions. Lithium can up-regulate this pathway by disrupting Glycogen synthase kinase-3β (GSK-3β). This action of Lithium can effectively counteract neuroinflammation and neurodegeneration. The current use of Lithium remains majorly confined to its use for episodes of mania in bipolar disorder (BD). However, recent literature gives insight into how Lithium can improve the visual field in glaucomatous eyes. Symptomatic improvement after lithium administration is seen as it has neuroprotective actions on the retinal ganglion cells (RGCs). Prolonged lithium use improves axonal regeneration and neuronal survival. Lithium also improves the worsening of symptoms in other dementia-related neurodegenerative diseases like Alzheimer’s and Parkinsonism. The physiological actions of Lithium can be utilized in providing effective, holistic therapy options in pathologically related senile degenerative disorders. Significantly better results can be obtained if Lithium therapy is given in conjunction with the drugs used to manage these disorders.
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14
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Ha YW, Jang H, Koh SB, Noh Y, Lee SK, Seo SW, Cho J, Kim C. Reduced brain subcortical volumes in patients with glaucoma: a pilot neuroimaging study using the region-of-interest-based approach. BMC Neurol 2022; 22:277. [PMID: 35879747 PMCID: PMC9310417 DOI: 10.1186/s12883-022-02807-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background While numerous neuroimaging studies have demonstrated that glaucoma is associated with smaller volumes of the visual cortices in the brain, only a few studies have linked glaucoma with brain structures beyond the visual cortices. Therefore, the objective of this study was to compare brain imaging markers and neuropsychological performance between individuals with and without glaucoma. Methods We identified 64 individuals with glaucoma and randomly selected 128 age-, sex-, and education level-matched individuals without glaucoma from a community-based cohort. The study participants underwent 3 T brain magnetic resonance imaging and neuropsychological assessment battery. Regional cortical thickness and subcortical volume were estimated from the brain images of the participants. We used a linear mixed model after adjusting for potential confounding variables. Results Cortical thickness in the occipital lobe was significantly smaller in individuals with glaucoma than in the matched individuals (β = − 0.04 mm, P = 0.014). This did not remain significant after adjusting for cardiovascular risk factors (β = − 0.02 mm, P = 0.67). Individuals with glaucoma had smaller volumes of the thalamus (β = − 212.8 mm3, P = 0.028), caudate (β = − 170.0 mm3, P = 0.029), putamen (β = − 151.4 mm3, P = 0.051), pallidum (β = − 103.6 mm3, P = 0.007), hippocampus (β = − 141.4 mm3, P = 0.026), and amygdala (β = − 87.9 mm3, P = 0.018) compared with those without glaucoma. Among neuropsychological battery tests, only the Stroop color reading test score was significantly lower in individuals with glaucoma compared with those without glaucoma (β = − 0.44, P = 0.038). Conclusions We found that glaucoma was associated with smaller volumes of the thalamus, caudate, putamen, pallidum, amygdala, and hippocampus. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02807-x.
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Affiliation(s)
- Yae Won Ha
- Department of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Heeseon Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Young Noh
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seung-Koo Lee
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jaelim Cho
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea. .,Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
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15
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Nagarajan N, Assi L, Varadaraj V, Motaghi M, Sun Y, Couser E, Ehrlich JR, Whitson H, Swenor BK. Vision impairment and cognitive decline among older adults: a systematic review. BMJ Open 2022; 12:e047929. [PMID: 34992100 PMCID: PMC8739068 DOI: 10.1136/bmjopen-2020-047929] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/03/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES There has been increasing epidemiological research examining the association between vision impairment (VI) and cognitive impairment and how poor vision may be a modifiable risk factor for cognitive decline. The objective of this systematic review is to synthesise the published literature on the association of VI with cognitive decline, cognitive impairment or dementia, to aid the development of interventions and guide public policies pertaining to the relationship between vision and cognition. METHODS A literature search was performed with Embase, Medline and Cochrane library databases from inception to March 2020, and included abstracts and articles published in peer-reviewed journals in English. Our inclusion criteria included publications that contained subjective/objective measures of vision and cognition, or a diagnosis of VI, cognitive impairment or dementia. Longitudinal or cross-sectional studies with ≥100 participants aged >50 years were included. The search identified 11 805 articles whose abstracts underwent screening by three teams of study authors. Data abstraction and quality assessment using the Effective Public Health Practice Project Quality Assessment Tool were performed by one author (NN). 10% of the articles underwent abstraction and appraisal by a second author (LA/VV), results were compared between both and were in agreement. RESULTS 110 full-text articles were selected for data extraction, of which 53 were cross-sectional, 43 longitudinal and 14 were case-control studies. The mean age of participants was 73.0 years (range 50-93.1). Ninety-one (83%) of these studies reported that VI was associated with cognitive impairment. CONCLUSION Our systematic review indicates that a majority of studies examining the vision-cognition relationship report that VI is associated with more cognitive decline, cognitive impairment or dementia among older adults. This synthesis supports the need for additional research to understand the mechanisms underlying the association between VI and cognitive impairment and to test interventions that mitigate the cognitive consequences of VI.
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Affiliation(s)
- Niranjani Nagarajan
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lama Assi
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - V Varadaraj
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mina Motaghi
- Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Yi Sun
- Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Elizabeth Couser
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joshua R Ehrlich
- Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
- Institute for healthcare policy and innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Heather Whitson
- Department of Medicine, Geriatrics, Duke University, Durham, North Carolina, USA
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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16
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Cui QN, Green D, Jethi M, Driver T, Porco TC, Kuo J, Lin SC, Stamper RL, Han Y, Chiu CS, Ramanathan S, Ward ME, Possin K, Ou Y. Individuals with and without normal tension glaucoma exhibit comparable performance on tests of cognitive function. Int J Ophthalmol 2021; 14:1721-1728. [PMID: 34804862 PMCID: PMC8569564 DOI: 10.18240/ijo.2021.11.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 03/16/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate aspects of cognition impacted by individuals with and without normal tension glaucoma. METHODS Fifty normal tension glaucoma (NTG) and 50 control patients ≥50y of age were recruited from the UCSF Department of Ophthalmology. Demographic data and glaucoma parameters were extracted from electronic medical records for both groups. Tests of executive function [Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER)] and learning and memory [California Verbal Learning Test-Second Edition (CVLT-II)] were administered to both NTG and controls. Race, handedness, best-corrected visual acuity, maximum intraocular pressure, optic nerve cup-to-disc ratio, visual field and optic nerve optical coherence tomography parameters, and a measure of general health (Charlson Comorbidity Index) were compared between NTG and controls as well as within NTG subgroups. Multivariate linear regression was used to compare group performances on the EXAMINER battery and CVLT-II while controlling for age, sex, and years of education. RESULTS NTG and controls were comparable with respect to age, sex, race, education, handedness, and the Charlson Comorbidity Index (P>0.05 for all). Performance on the EXAMINER composite score and the CVLT-II did not differ between NTG and controls (P>0.05 for both). CONCLUSION This is the first prospective study in which the cognitive function of subject with NTG were evaluated using a comprehensive, computerized neurocognitive battery. Subjects with NTG do not perform worse than unaffected controls on tests of executive function, learning, and memory. Results do not support the hypothesis that individuals with NTG are at higher risk for cognitive dysfunction and/or dementia.
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Affiliation(s)
- Qi N. Cui
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
- University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - David Green
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
| | - Mohit Jethi
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
| | - Todd Driver
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
| | - Travis C. Porco
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California 94143, USA
| | - Jane Kuo
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
| | - Shan C. Lin
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
- Glaucoma Center of San Francisco, San Francisco, California 94105, USA
| | - Robert L. Stamper
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
| | - Ying Han
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
| | - Cynthia S. Chiu
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
| | - Saras Ramanathan
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
| | - Michael E. Ward
- Department of Neurology, University of California San Francisco, San Francisco, California 94143, USA
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Katherine Possin
- Department of Neurology, University of California San Francisco, San Francisco, California 94143, USA
| | - Yvonne Ou
- Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
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17
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Arrigo A, Aragona E, Saladino A, Arrigo D, Fantaguzzi F, Battaglia Parodi M, Bandello F. Cognitive Dysfunctions in Glaucoma: An Overview of Morpho-Functional Mechanisms and the Impact on Higher-Order Visual Function. Front Aging Neurosci 2021; 13:747050. [PMID: 34690746 PMCID: PMC8526892 DOI: 10.3389/fnagi.2021.747050] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 08/27/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Glaucoma is a chronic, vision-threatening disease, and a major cause of legal blindness. The current view is no longer limited to the progressive optic nerve injury, since growing evidence strongly support the interpretation of glaucoma as a complex neurodegenerative disease. However, the precise pathogenic mechanisms leading to the onset and progression of central nervous system (CNS) impairment, and the functional consequences of this damage, are still partially understood. The main aim of this review is to provide a complete and updated overview of the current knowledge regarding the CNS involvement in glaucoma, and the possible therapeutic perspectives. Methods: We made a careful survey of the current literature reporting all the relevant findings related to the cognitive dysfunctions occurring in glaucoma, with specific remarks dedicated on the higher-order visual function impairment and the possible employment of neuroprotective agents. Results: The current literature strongly support the interpretation of glaucoma as a multifaceted chronic neurodegenerative disease, widely affecting the CNS. The cognitive impairment may vary in terms of higher-order functions involvement and in the severity of the degeneration. Although several neuroprotective agents are currently available, the development of new molecules represents a major topic of investigation for future clinical trials. Conclusions: Glaucoma earned the right to be fully considered a neurodegenerative disease. Glaucomatous patients may experience a heterogeneous set of visual and cognitive symptoms, progressively deteriorating the quality of life. Neuroprotection is nowadays a necessary therapeutic goal and a future promising way to preserve visual and cognitive functions, thus improving patients' quality of life.
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Affiliation(s)
- Alessandro Arrigo
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
| | - Emanuela Aragona
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
| | - Andrea Saladino
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
| | - Davide Arrigo
- School of Medicine, University of Messina, Messina, Italy
| | - Federico Fantaguzzi
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
| | | | - Francesco Bandello
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
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18
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Zhao W, Lv X, Wu G, Zhou X, Tian H, Qu X, Sun H, He Y, Zhang Y, Wang C, Tian J. Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies. Front Med (Lausanne) 2021; 8:688551. [PMID: 34504851 PMCID: PMC8423132 DOI: 10.3389/fmed.2021.688551] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
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; I 2 = 83%], all-cause dementia (adjusted RR: 1.08, 95% CI: 0.97-1.19, P = 0.15; I 2 = 79%), or non-AD dementia (adjusted RR: 1.05 95% CI: 0.91-1.21, P = 0.49; I 2 = 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.
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Affiliation(s)
- Wenmei Zhao
- Zunyi Medical University, Zunyi, China.,Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Xia Lv
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Guangjie Wu
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Xia Zhou
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Helan Tian
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Xiang Qu
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Hongpeng Sun
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yingying He
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yingyue Zhang
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Chuan Wang
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jinyong Tian
- Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, China
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19
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Loughman J, Loskutova E, Butler JS, Siah WF, O’Brien C. Macular Pigment Response to Lutein, Zeaxanthin, and Meso-zeaxanthin Supplementation in Open-Angle Glaucoma. OPHTHALMOLOGY SCIENCE 2021; 1:100039. [PMID: 36247822 PMCID: PMC9562333 DOI: 10.1016/j.xops.2021.100039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 01/30/2023]
Abstract
Purpose To evaluate macular pigment response to carotenoid supplementation in glaucomatous eyes. Design Double-masked, randomized, placebo-controlled clinical trial, the European Nutrition in Glaucoma Management Study (ClinicalTrials.gov identifier, NCT04460365). Participants Sixty-two participants (38 men, 24 women) with a diagnosis of open-angle glaucoma were enrolled. Forty-two were randomized to receive the active supplement, 20 participants were allocated to placebo. Methods Macular pigment optical density (MPOD) was measured by autofluorescence using the Heidelberg Spectralis scanning laser ophthalmoscope. Macular pigment optical density volume within the central 6° of retinal eccentricity as well as MPOD at 0.23°, 0.51°, 0.74°, and 1.02° were recorded at baseline and at 6-month intervals over 18 months. Visual function was assessed using visual acuity, mesopic and photopic contrast sensitivity under glare conditions, photo stress recovery time, microperimetry, and Glaucoma Activities Limitation 9 questionnaire. Advanced glaucoma module scans of retinal nerve fiber layer thickness and ganglion cell complex thickness over the central 6° of retinal eccentricity also were completed at each study visit. Main Outcome Measures Change in MPOD after supplementation with 10 mg lutein, 2 mg zeaxanthin, and 10 mg meso-zeaxanthin or placebo over 18 months. Results A mixed-model repeated measures analysis of variance revealed a statistically significant increase in MPOD volume (significant time effect: F(3,111) = 89.31, mean square error (MSE) = 1656.9; P < 0.01). Post hoc t tests revealed a significant difference in MPOD volume at each study visit for the treatment group (P < 0.01 for all), but no change in the placebo group (P > 0.05 for all). A statistically significant increase in mesopic contrast sensitivity under glare conditions was noted at 18 months in the treatment group, but not placebo. No other structural or functional changes were observed. No serious adverse events were noted during the trial. Conclusions Macular pigment can be augmented in glaucomatous eyes by supplementation with a formulation containing the carotenoids lutein, zeaxanthin, and meso-zeaxanthin. The greatest relative benefit was observed in those with the lowest baseline levels, but increases were noted across all participants and each retinal eccentricity. The potential benefits of MP augmentation for macular health in glaucoma merit further long-term evaluation.
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20
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Kuźma E, Littlejohns TJ, Khawaja AP, Llewellyn DJ, Ukoumunne OC, Thiem U. Visual Impairment, Eye Diseases, and Dementia Risk: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2021; 83:1073-1087. [PMID: 34397414 DOI: 10.3233/jad-210250] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Visual impairment and eye diseases have been associated with dementia, though with mixed findings and often in cross-sectional studies. OBJECTIVE To identify prospective studies investigating associations between visual impairment or common eye diseases and risk of all-cause dementia or key dementia subtypes. METHODS We searched Medline, PsycINFO, and Embase from inception to January 2020. We also conducted backward and forward citation searches of included studies and set up alerts to identify studies published after the search date. Random-effects meta-analysis was used to combine adjusted estimates across studies. RESULTS Thirty studies met our eligibility criteria. For visual impairment, pooled estimates indicated an increased risk of all-cause dementia (37,705 participants, 3,415 cases, risk ratio [RR] = 1.38, 95%confidence interval [CI]: 1.19-1.59, I2 = 28.6%). Pooled estimates also suggested an increased dementia risk associated with cataract (6,659 participants, 1,312 cases, hazard ratio [HR] = 1.17, 95%CI 1.00-1.38, I2 = 0.0%) and diabetic retinopathy (43,658 participants, 7,060 cases, HR = 1.34, 95%CI 1.11-1.61, I2 = 63.9%), respectively. There was no evidence of an association between glaucoma (175,357 participants, 44,144 cases, HR = 0.97, 95%CI 0.90-1.04, I2 = 51.5%) or age-related macular degeneration (7,800,692 participants, > 2,559 cases, HR = 1.15, 95%CI 0.88-1.50, I2 = 91.0%) and risk of dementia, respectively. CONCLUSION As visual impairment, cataract, and diabetic retinopathy are associated with an increased likelihood of developing dementia, early diagnosis may help identify those at risk of dementia. Given most causes of visual impairment are treatable or preventable, the potential for dementia prevention warrants further investigation.
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Affiliation(s)
- Elżbieta Kuźma
- Albertinen-Haus Centre for Geriatrics and Gerontology, University of Hamburg, Hamburg, Germany
| | - Thomas J Littlejohns
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - David J Llewellyn
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom.,Alan Turing Institute, London, United Kingdom
| | - Obioha C Ukoumunne
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, Exeter, United Kingdom
| | - Ulrich Thiem
- Albertinen-Haus Centre for Geriatrics and Gerontology, University of Hamburg, Hamburg, Germany.,University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Lower Cognitive Function in Patients with Functionally and Structurally Severe Glaucoma: The LIGHT Study. J Glaucoma 2021; 30:882-886. [PMID: 34387257 DOI: 10.1097/ijg.0000000000001923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/29/2021] [Indexed: 11/26/2022]
Abstract
PRECIS This cross-sectional study of 172 patients with glaucoma showed that functional and structural glaucoma damage was significantly associated with cognitive impairment independent of age and visual acuity. PURPOSE The aim of this study was to determine whether functional and structural glaucoma damage is associated with cognitive function. PATIENTS AND METHODS This was a cross-sectional analysis comprising 172 patients with glaucoma with a mean age of 70.6 years. Functional glaucoma severity was evaluated according to the visual field mean deviation (severe, mean deviation ≤ -12▒dB; mild, mean deviation > -12▒dB), and structural glaucoma severity was determined based on circumpapillary retinal nerve fiber layer (RNFL) thickness. The main outcome measure was cognitive impairment defined by a mini-mental state examination (MMSE) score of ≤26 and MMSE-blind score of ≤16. RESULTS The prevalence of patients with cognitive impairment (MMSE score ≤26) was significantly higher in the severe glaucoma group than in the mild glaucoma group (33.3% vs. 15.7%; P=0.010, respectively). Similar results were obtained in the analyses with MMSE-blind score of ≤16 (14.7% vs. 1.4%; P=0.003, respectively). Multivariable logistic regression analysis adjusted for potential confounders, including age, body mass index, education, visual acuity, hypertension, diabetes, and depressive symptoms, indicated a higher odds ratio for cognitive impairment (MMSE score ≤26) in patients with severe glaucoma than in those with mild glaucoma (odds ratio, 2.62; 95% confidence interval, 1.006-6.84; P=0.049) and in relation to a 10-μm thinning of the RNFL (odds ratio, 1.42; 95% confidence interval, 1.05-1.93; P=0.025). CONCLUSION Functional and structural glaucoma damage was significantly associated with lower cognitive function independent of age and visual acuity in a glaucoma cohort.
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22
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Belamkar AV, Mansukhani SA, Savica R, Spiegel MR, Hodge DO, Sit AJ. Incidence of Dementia in Patients With Open-angle Glaucoma: A Population-based Study. J Glaucoma 2021; 30:227-234. [PMID: 33394844 PMCID: PMC8132918 DOI: 10.1097/ijg.0000000000001774] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
PRECIS In this population-based study of 509 open-angle glaucoma (OAG) patients over a 36-year period, we identified a decreased rate of developing dementia compared with the rate in the general population. PURPOSE The aim was to determine the incidence of dementia and Alzheimer disease (AD) among patients with OAG. PATIENTS AND METHODS Retrospective, population-based cohort study. All residents of Olmsted County, Minnesota (≥40 y) who were diagnosed with OAG between January 1, 1965 and December 31, 2000, were eligible for inclusion in this study. A total of 509 patients were included over the 36-year period. The cumulative probability of developing dementia was calculated and compared with the population risk of dementia. RESULTS Of the 509 patients included, 300 (58.9%) were female, the median age was 67.5 years, and 278 patients (54.6%) had primary OAG. Other subgroups were pseudoexfoliation in 15.1%, treated ocular hypertension in 14.1%, normal tension glaucoma in 10.6%, and pigmentary glaucoma in 5.5% of the patients. Respectively, 118 (23.0%) and 99 (19.4%) patients developed dementia and AD. The 10-year cumulative probability of developing dementia and AD was 12.0% and 9.9%, with a 95% confidence interval of 9.3%-15.3% and 7.5%-13%, respectively. The observed 10-year incidence of dementia and AD were significantly lower than the expected population incidence (19.0% and 19.0%; P<0.001). Older age at diagnosis of glaucoma was a strong predictor for the development of dementia by multivariate analysis (hazard ratio: 3.31, 95% confidence interval: 2.61-4.20, P<0.001). CONCLUSION The risk of developing dementia or AD was decreased in OAG patients compared with the general population. OAG with onset at a later age may present as a different etiopathogenetic entity compared with onset at a younger age, and represent the optic nerve findings of generalized neurodegenerative processes.
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Affiliation(s)
| | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester,
Minnesota
| | - Matthew R. Spiegel
- Department of Health Sciences Research, Mayo Clinic,
Jacksonville, Florida
| | - David O. Hodge
- Department of Health Sciences Research, Mayo Clinic,
Jacksonville, Florida
| | - Arthur J. Sit
- Department of Ophthalmology, Mayo Clinic, Rochester,
Minnesota
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23
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Xiao Z, Wu W, Zhao Q, Zhang J, Hong Z, Ding D. Sensory impairments and cognitive decline in older adults: A review from a population-based perspective. AGING AND HEALTH RESEARCH 2021. [DOI: 10.1016/j.ahr.2020.100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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24
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Vidal KS, Suemoto CK, Moreno AB, Duncan B, Schmidt MI, Maestri M, Barreto SM, Lotufo PA, Bertola L, Bensenor IM, Brunoni AR. Association between cognitive performance and self-reported glaucoma in middle-aged and older adults: a cross-sectional analysis of ELSA-Brasil. ACTA ACUST UNITED AC 2020; 53:e10347. [PMID: 33146284 PMCID: PMC7643934 DOI: 10.1590/1414-431x202010347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/27/2020] [Indexed: 12/31/2022]
Abstract
Recent evidence suggests that glaucoma and Alzheimer's disease are neurodegenerative diseases sharing common pathophysiological and etiological features, although findings are inconclusive. We sought to investigate whether self-reported glaucoma patients without dementia present poorer cognitive performance, an issue that has been less investigated. We employed cross-sectional data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) and included participants ≥50 years of age without a known diagnosis of dementia and a self-reported glaucoma diagnosis. We excluded those with previous stroke, other eye conditions, and using drugs that could impair cognition. We evaluated cognition using delayed word recall, phonemic verbal fluency, and trail making (version B) tests. We used multinomial linear regression models to investigate associations between self-reported glaucoma with cognition, adjusted by several sociodemographic and clinical variables. Out of 4,331 participants, 139 reported glaucoma. Fully-adjusted models showed that self-reported glaucoma patients presented poorer performance in the verbal fluency test (β=-0.39, 95%CI=-0.64 to -0.14, P=0.002), but not in the other cognitive assessments. Thus, our results support the hypothesis that self-reported glaucoma is associated with poor cognitive performance; however, longitudinal data are necessary to corroborate our findings.
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Affiliation(s)
- K S Vidal
- Laboratório da Visão, Instituto de Psicologia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - C K Suemoto
- Divisão de Geriatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A B Moreno
- Departamento de Epidemiologia e Métodos Quantitativos na Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - B Duncan
- Departamento de Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - M I Schmidt
- Departamento de Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - M Maestri
- Departamento de Oftalmologia e Otorrinolaringologia, Faculdade de Medicina, Universidade do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - S M Barreto
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - P A Lotufo
- Departamento de Clínica Médica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.,Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - L Bertola
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - I M Bensenor
- Departamento de Clínica Médica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.,Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A R Brunoni
- Departamento de Clínica Médica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.,Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.,Laboratório de Neurociências, Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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25
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Vidal KSM, Bertola L, Suemoto CK, Moreno AB, Duncan B, Schmidt MI, Maestri M, Barreto SM, Lotufo PA, Benseñor IM, Brunoni AR. Glaucoma, but not cataracts, predicts lower verbal fluency performance: 3.8-year follow-up from the ELSA-Brasil study. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:871-883. [PMID: 33073671 DOI: 10.1080/13825585.2020.1837723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Glaucoma, cataracts, and cognitive decline are most common in older ages. Although cross-sectional studies showed that these disorders are associated, follow-up studies are lacking. To investigate this issue, baseline and follow-up data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were employed. We evaluated participants ≥ 55 years-old at follow-up without diagnosis of dementia, stroke, and other eye conditions except for glaucoma and cataracts. Cognition was evaluated using delayed word recall, verbal fluency, and trail making (version B) tests. Regression models were employed to investigate associations between glaucoma and cognition, adjusted by several confounders. Out of 3,867 participants, 379 and 118 presented cataracts and glaucoma, respectively. Only glaucoma was apredictor of lower verbal fluency (B = -0.23, 95% CI -035 to -012, p< 0.001). Other associations were not significant (ps>0.57). Our results suggest that glaucoma may be related to declining cognition.
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Affiliation(s)
| | - Laiss Bertola
- Department of Internal Medicine, Faculdade De Medicina Da Universidade De São Paulo, São Paulo, Brazil
| | - Claudia K Suemoto
- Division of Geriatrics, Faculdade De Medicina Da Universidade De São Paulo, São Paulo, Brazil
| | - Arlinda B Moreno
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Fundação Oswaldo Cruz, Rio De Janeiro, Brazil
| | - Bruce Duncan
- Postgraduate Studies Program in Epidemiology and Hospital De Clínicas De Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Maria Inês Schmidt
- Postgraduate Studies Program in Epidemiology and Hospital De Clínicas De Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Marcelo Maestri
- Department of Ophthalmology and Otorhinolaryngology, Faculdade De Medicina Da Universidade Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Sandhi M Barreto
- Faculdade De Medicina & Hospital Das Clínicas, Universidade Federal De Minas Gerais, Minas Gerais, Brazil
| | - Paulo A Lotufo
- Department of Internal Medicine, Faculdade De Medicina Da Universidade De São Paulo, São Paulo, Brazil.,Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade De São Paulo, São Paulo, Brazil
| | - Isabela M Benseñor
- Department of Internal Medicine, Faculdade De Medicina Da Universidade De São Paulo, São Paulo, Brazil.,Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade De São Paulo, São Paulo, Brazil
| | - Andre R Brunoni
- Department of Internal Medicine, Faculdade De Medicina Da Universidade De São Paulo, São Paulo, Brazil.,Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade De São Paulo, São Paulo, Brazil.,Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade De Medicina Da Universidade De São Paulo, São Paulo, Brazil
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26
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Xiao Z, Wu W, Zhao Q, Liang X, Luo J, Ding D. Association of Glaucoma and Cataract with Incident Dementia: A 5-Year Follow-Up in the Shanghai Aging Study. J Alzheimers Dis 2020; 76:529-537. [PMID: 32538850 DOI: 10.3233/jad-200295] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wanqing Wu
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoniu Liang
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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27
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Umunakwe O, Gupta D, Tseng H. Association of Open-Angle Glaucoma with Non-Alzheimer's Dementia and Cognitive Impairment. Ophthalmol Glaucoma 2020; 3:460-465. [PMID: 32830102 DOI: 10.1016/j.ogla.2020.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 12/13/2022]
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.
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Affiliation(s)
- Obinna Umunakwe
- Department of Ophthalmology, Duke University, Durham, North Carolina.
| | - Divakar Gupta
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Henry Tseng
- Department of Ophthalmology, Duke University, Durham, North Carolina.
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28
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Kaido M, Fukui M, Kawashima M, Negishi K, Tsubota K. Relationship between visual function and cognitive function in the elderly: A cross-sectional observational study. PLoS One 2020; 15:e0233381. [PMID: 32428010 PMCID: PMC7236991 DOI: 10.1371/journal.pone.0233381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/03/2020] [Indexed: 11/18/2022] Open
Abstract
It has been suggested that functional visual acuity (VA) testing may be able to measure both the visual performance and cognitive ability needed for driving and help to reduce the number of road traffic accidents. The aim of this study was to investigate the relationship between visual ability and cognitive function in healthy elderly subjects. The study included 34 eyes with a decimal best-corrected visual acuity (VA) ≥1.0 in 34 subjects (16 men, 18 women; mean age 72.7 ± 6.1 [range, 61-83] years) with the same type of monofocal intraocular lens implant. Using the score on the Japanese version of the Mini-Mental State Examination (MMSE) questionnaire, the subjects were divided into a mild cognitive impairment (MCI) group (score <28) and a normal cognition (NC) group (score ≥28). Visual ability was evaluated by functional VA testing. Functional VA was significantly lower in the MCI group (n = 10) than in the NC group (n = 24; P<0.02). There was no significant difference in best-corrected VA between the two groups. High correlations were found between the MMSE score and the logMAR functional VA (r = -0.36, P = 0.04), standard deviation of functional VA (r = -0.39, P = 0.02), and the visual maintenance ratio (r = 0.34, P = 0.048). In summary, despite a good best-corrected VA, deterioration in visual ability was detected in elderly individuals with MCI when measured by the functional VA test. Functional VA could be used to evaluate the integrated visual ability associated with age-related cognitive decline and have applications that help to reduce the disproportionately high rate of road traffic accidents in the elderly.
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Affiliation(s)
- Minako Kaido
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Wada Eye Clinic, Chiba, Japan
| | - Masaki Fukui
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Tokyo Medical Center, Tokyo, Japan
| | - Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Tsubota Laboratory, Inc., Tokyo, Japan
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29
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Varin M, Kergoat MJ, Belleville S, Li G, Rousseau J, Roy-Gagnon MH, Moghadaszadeh S, Freeman EE. Age-Related Eye Disease and Cognitive Function. Ophthalmology 2020; 127:660-666. [DOI: 10.1016/j.ophtha.2019.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022] Open
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30
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Kuo FH, Chung JF, Hsu MY, Lee CY, Huang JY, Hsieh MJ, Yang SF. Impact of the Severities of Glaucoma on the Incidence of Subsequent Dementia: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072426. [PMID: 32252450 PMCID: PMC7177931 DOI: 10.3390/ijerph17072426] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 12/21/2022]
Abstract
The aim of the present study was to survey the relationship between the severity of glaucoma and subsequent dementia using the National Health Insurance Research Database (NHIRD) in Taiwan. Subjects with glaucoma were selected into the study group after an exclusion process, and each subject in the study group was propensity score-matched to another non-glaucoma patient that constituted the control group. The Cox proportional hazard regression that considered multiple potential risk factors of dementia was used to yield the adjusted hazard ratios (aHR) of dementia in different severities of glaucoma. There were 1185 (5.63 percent) subjects in the study group and 1119 (5.32 percent) patients in the control group that developed dementia. After adjusting for multiple confounders, there were no differences in the rate of any dementia (aHR: 0.961, 95% CI: 0.886–1.043, p = 0.3443), vascular dementia (aHR: 0.928, 95% CI: 0.846–1.018, p = 0.1154), Alzheimer’s disease (aHR: 1.018, 95% CI: 0.761–1.362, p = 0.9025) or Parkinson’s disease (aHR: 1.021, 95% CI: 0.886–1.176, p = 0.7744) between the study and the control groups. Regarding the disease severity of glaucoma, no difference was found in any type of dementia whether the glaucoma patients received less than two medical treatments, received more than two medical treatments, received drainage surgeries or received destructive surgeries. In conclusion, the different severities of glaucoma do not alter the incidence of subsequent dementia.
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Affiliation(s)
- Fu-Hsuan Kuo
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (F.-H.K.); (J.-Y.H.)
- Neurological Institute, Taichung Veteran General Hospital, Taichung 407, Taiwan
| | - Jui-Fu Chung
- Radiology Division, Chiayi Branch, Taichung Veteran General Hospital, Chiayi 600, Taiwan;
| | - Min-Yen Hsu
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 500, Taiwan;
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (F.-H.K.); (J.-Y.H.)
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
| | - Ming-Ju Hsieh
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (F.-H.K.); (J.-Y.H.)
- Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
- Correspondence: (S.-F.Y.); (M.-J.H.)
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (F.-H.K.); (J.-Y.H.)
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
- Correspondence: (S.-F.Y.); (M.-J.H.)
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Sadykov E, Studnička J, Hosák L, Siligardou MR, Elfurjani H, Hoikam JL, Kugananthan S, Petrovas A, Amjad T. The Interface Between Psychiatry and Ophthalmology. ACTA MEDICA (HRADEC KRÁLOVÉ) 2019; 62:45-51. [PMID: 31362812 DOI: 10.14712/18059694.2019.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this article is to review the interface between psychiatry and ophthalmology at several levels, such as the influence of psychopharmacology on eye disorders, the occurrence of psychiatric symptoms in eye diseases, and the neuroophthalmological examination methods supporting the validity of psychiatric diagnoses. MATERIALS AND METHODS We searched the PubMed computer database for the key words "Psychiatry" and "Ophthalmology" on the 28th of August, 2018 to obtain relevant articles which were consequently summarized. RESULTS The results showed that most patients with ocular disease simultaneously have one or more psychiatric symptoms. We also found a prevalence of eye-related side effects in patients who use psychiatric drugs. At the same time, we observed that some ophthalmology methods of diagnostics can be used as diagnostic tools in psychiatry. CONCLUSIONS Most studies showed a significant relation between psychiatry and ophthalmology, such as eye symptoms and diseases following long-term use of psychotropics as well as psychiatric symptoms and syndromes in patients with eye disorders. Our review may be beneficial to psychiatrists, ophthalmologists, and, last but not least, the patients themselves.
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Affiliation(s)
- Evgenii Sadykov
- Department of Psychiatry, Charles University, Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic. .,Department of Psychiatry, University Hospital Hradec Králové, Hradec Králové, Czech Republic.
| | - Jan Studnička
- Department of Ophthalmology, Charles University, Faculty of Medicine in Hradec Králové, and University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Ladislav Hosák
- Department of Psychiatry, Charles University, Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic.,Department of Psychiatry, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | - Hajer Elfurjani
- Charles University, Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic
| | - Jessica Leung Hoikam
- Charles University, Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic
| | | | - Anastasios Petrovas
- Charles University, Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic
| | - Talal Amjad
- Charles University, Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic
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Kinouchi R, Ishiko S, Hanada K, Hayashi H, Mikami D, Tani T, Zenimaru T, Kawai M, Nakabayashi S, Kinouchi M, Yoshida A. A low meat diet increases the risk of open-angle glaucoma in women-The results of population-based, cross-sectional study in Japan. PLoS One 2018; 13:e0204955. [PMID: 30278082 PMCID: PMC6168154 DOI: 10.1371/journal.pone.0204955] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/16/2018] [Indexed: 11/19/2022] Open
Abstract
Background Studies identifying modifiable lifestyle risk factors related to open-angle glaucoma (OAG) are limited, especially from Asian countries. This study aimed to identify lifestyle risk factors for OAG in a Japanese population. Methods and findings This population-based, cross-sectional study recruited Japanese participants aged 40 years or older from January 2013 to March 2015. We took fundus photographs for OAG screening, determined lifestyle and health characteristics through a questionnaire and performed physical examinations. The participants who had suspect findings in the fundus photographs were sent for a detailed ophthalmic examination to diagnose OAG. Lifestyle and heath characteristics were statistically compared between the OAG and non-OAG participants. A total of 1583 participants were included in the study, of which 42 had OAG and 1541 did not have OAG. The number of days per week that the female participants consumed meat (mean±SD; OAG: 1.7±1.2 days, non-OAG: 2.7±1.5 days) was negatively associated with OAG (OR = 0.61; 95% CI: 0.43–0.88; p = 0.007). Higher intraocular pressure was positively associated with OAG in men (OR = 1.20; 95% CI: 1.05–1.38, p = 0.009). No significant difference between participants with and without OAG was observed for a range of other lifestyle factors and health criteria including self-report of diabetes, number of family living together, body mass index, blood pressure, pulse rate, coffee drinking, tea drinking, alcohol drinking, number of fruits consumed per day and days of fish consumption per week. Conclusions A higher weekly consumption of meat appears to be negatively associated with OAG in Japanese women. Increasing the dietary intake of meat can contribute to reducing the risk of developing OAG.
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Affiliation(s)
- Reiko Kinouchi
- Medicine and Engineering Combined Research Institute, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
- * E-mail:
| | - Satoshi Ishiko
- Medicine and Engineering Combined Research Institute, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Kazuomi Hanada
- Medicine and Engineering Combined Research Institute, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Hiroki Hayashi
- Medicine and Engineering Combined Research Institute, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Daiki Mikami
- Medicine and Engineering Combined Research Institute, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Tomofumi Tani
- Department of Ophthalmology, Rumoi Municipal Hospital, Rumoi, Hokkaido, Japan
| | | | - Motofumi Kawai
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Seigo Nakabayashi
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Motoshi Kinouchi
- Department of Dermatology, Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan
| | - Akitoshi Yoshida
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Association between Open-Angle Glaucoma and the Risks of Alzheimer's and Parkinson's Diseases in South Korea: A 10-year Nationwide Cohort Study. Sci Rep 2018; 8:11161. [PMID: 30042382 PMCID: PMC6057948 DOI: 10.1038/s41598-018-29557-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/14/2018] [Indexed: 01/02/2023] Open
Abstract
We aimed to investigate the risks of Alzheimer’s (AD) and Parkinson’s disease (PD) in the 10 years following diagnosis of open-angle glaucoma (OAG) using a nationwide cohort. This propensity score-matched retrospective cohort study included 1,025,340 subjects from the Korean National Health Insurance Service National Sample Cohort database. The OAG group (n = 1,469) included patients who were initially diagnosed with OAG between 2004 and 2007, and the subjects in the comparison group were matched in a 1:5 ratio using propensity scores. Cox regression analyses were performed to investigate the risks of developing AD or PD. The diagnosis of OAG was significantly associated with an increased incidence of AD (hazard ratio [HR] = 1.403, 95% confidence interval [CI] 1.180–1.669, p < 0.001), but not PD (HR = 0.995, 95% CI 0.620–1.595, p = 0.983) after adjusting for possible confounding factors. In subgroup analyses, participants with OAG aged ≥65 years were more likely to develop AD compared with those aged <65 years, and female OAG patients had a greater risk of developing AD than males. Patients diagnosed with OAG have a higher risk of developing AD, but not PD, and the risk differed according to age and sex.
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Sahoo S, Thevi T, Soe HHK. Association of Well-Being Index and Cognitive Impairment with Primary Open Angle Glaucoma Patients of Malaysia: A Case-Control Study. Malays J Med Sci 2018; 25:96-100. [PMID: 29599639 PMCID: PMC5862055 DOI: 10.21315/mjms2018.25.1.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 12/05/2017] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study was to determine the association of well-being and cognitive impairment with primary open angle glaucoma (POAG) patients attending a tertiary care hospital in Malaysia. Fifty-four individuals were recruited for study as cases were matched with 60 individuals as the control subjects, and data were collected using the WHO well-being index and the validated 6-item cognitive impairment test dementia test. The results showed that there was no significant association between gender, ethnicity, socioeconomic status and POAG. Patients with POAG had significantly lower well-being index scores (mean 67.93) than the control group (mean 81.60) with P-value < 0.001. Similarly, patients with POAG had a significantly higher score of cognitive impairment (CIT test) (mean 6.15) compared to the control group (mean 0.40) with P-value < 0.001. Consequently, POAG is likely to be associated with higher cognitive impairment and lower well-being index.
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Affiliation(s)
- Soumendra Sahoo
- Melaka Manipal Medical College-Community Medicine, Jalan Batu Hampar Bukit Baru, 75150 Melaka, Malaysia
| | - Thanigasalam Thevi
- Hospital Melaka-Ophthalmology, Jalan Mufti Haji Khalil, 75400 Melaka, Malaysia
| | - Htoo Htoo Kyaw Soe
- Melaka Manipal Medical College-Community Medicine, Jalan Batu Hampar Bukit Baru, 75150 Melaka, Malaysia
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Association of Neovascular Glaucoma with Risk of Stroke: A Population-Based Cohort Study. J Ophthalmol 2017; 2017:1851568. [PMID: 28928981 PMCID: PMC5591904 DOI: 10.1155/2017/1851568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/06/2017] [Accepted: 07/05/2017] [Indexed: 11/17/2022] Open
Abstract
Neovascular glaucoma (NVG), caused by ocular ischemia, is a serious ocular disease complicated by intractably increased intraocular pressure. Cerebrovascular accidents are classified into ischemic and hemorrhagic stroke. Based on the similar pathogenic mechanisms of NVG and ischemic stroke, we investigated the relationship between NVG and stroke by using a nationally representative sample. This study included 416 NVG patients and 4160 controls. Medical comorbidities were also evaluated. The cumulative incidence of ischemic stroke was 15.6% higher in the NVG cohort than in the control cohort (p < 0.001); the incidence density rates of stroke were 3.80 and 1.19 per 10,000 person-years in the NVG and control cohorts, respectively. According to the multivariable Cox regression results, the estimated adjusted hazard ratio (aHR) of stroke was 2.07 (95% confidence interval (CI) = 1.41–3.02) for the NVG cohort. Furthermore, the NVG cohort was 2.24-fold more likely to develop ischemic stroke (95% CI = 1.51–3.32). The risk of ischemic stroke was higher in patients with hypertension (aHR = 2.09, 95% CI = 1.55–2.82) and in patients with diabetic retinopathy (aHR = 1.69, 95% CI = 1.05–2.72). Notably, patients with NVG have a higher risk of ischemic stroke, but not hemorrhagic stroke.
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Maurano STP, da Silva DJ, Ávila MP, Magacho L. Cognitive evaluation of patients with glaucoma and its comparison with individuals with Alzheimer’s disease. Int Ophthalmol 2017; 38:1839-1844. [DOI: 10.1007/s10792-017-0658-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 07/15/2017] [Indexed: 10/19/2022]
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