Risk of dementia in newly diagnosed glaucoma: a nationwide cohort study in Korea.

PURPOSE: To investigate the risk of dementia in participants with newly diagnosed glaucoma.

DESIGN: A nationwide cohort study using authorized data provided by the Korean National Health Insurance Service (NHIS).

PARTICIPANTS: A total of 788,961 participants aged ≥ 45 years in 2006, who did not have dementia or glaucoma between 2002 and 2005, were included.

METHODS: Data were collected from a nationwide population-based retrospective cohort study using the Korean NHIS database. From January 2006 to December 2017, participants were tracked for the diagnosis of glaucoma or dementia using claims data. The prospective association between newly diagnosed glaucoma and the risk of dementia was investigated using a multivariable Cox proportional hazard model adjusted for age, sex, behavioral factors, and systemic and ocular comorbidities.

MAIN OUTCOME MEASURES: Hazard ratios and 95% confidence intervals for dementia development according to the parameters, including glaucoma diagnosis.

RESULTS: Overall, 7.0% of the participants developed dementia after an average of 7.4 years. A newly diagnosed glaucoma was associated with a higher risk of dementia (hazards ratio [HR] 1.89, 95% confidence interval [CI] 1.57 to 2.27) independent of age, sex, body mass index, income, smoking and drinking status, visual acuity, and other systemic comorbidities, such as diabetes, hypertension, stroke, and depression. An association between the risk of dementia and glaucoma was noted in participants with Alzheimer's disease (AD) but not in those with vascular dementia. The risk of dementia in relation to glaucoma was higher in older participants (HR = 3.15 (≥ 65 years) vs. 1.56 (< 65 years), P < 0.0001).

CONCLUSION: This nationwide cohort study found that individuals with newly diagnosed glaucoma were at a higher risk of developing dementia, particularly AD. This association was greater among older individuals in the studied population.