Could Mid- to Late-Onset Glaucoma Be Associated with an Increased Risk of Incident Dementia? A Nationwide Retrospective Cohort Study

This study aimed to investigate the possible link between glaucoma and dementia using a nationwide cohort sample of data. The glaucoma group (n = 875) included patients diagnosed between 2003 and 2005, aged over 55 years; the comparison group was selected using propensity score matching (n = 3500). The incidence of all-cause dementia was 18.67 (7014.7 person-years) among those with glaucoma aged over 55 years. The glaucoma group developed all-cause dementia more frequently than those in the comparison group (adjusted hazard ratio (HR) = 1.43, 95% confidence interval (CI), 1.17-1.74). In a subgroup analysis, primary open-angle glaucoma (POAG) showed a significantly increased adjusted HR for all-cause dementia events (1.52, 95% CI: 1.23-1.89), whereas we could not find any significant association in patients with primary angle-closure glaucoma (PACG). Additionally, POAG patients showed an increased risk of the development of Alzheimer's disease (adjusted HR = 1.57, 95% CI, 1.21-2.04) and Parkinson's disease (adjusted HR = 2.29, 95% CI, 1.46-3.61), but there was no significant difference in PACG patients. Moreover, the risk of Alzheimer's disease and Parkinson's disease was higher within 2 years of POAG diagnosis. Although our findings have some limitations, such as confounding factor bias, we suggest that clinicians should pay attention to the early detection of dementia in patients with POAG.