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.
Highlights
Glaucoma is one of the leading causes of preventable blindness worldwide [1]
We found a significant association between presence of glaucoma and lower performance in the phonemic verbal fluency test for both models, but not for the delayed word recall and the trail making tests
The present study investigated the cognitive performance of participants with and without self-reported glaucoma, in a sample of 4331 participants X50 years of age with no history of stroke, neurocognitive disorders, cataracts, or retinal diseases, and not using drugs that interfered at cognitive functioning
Summary
Glaucoma is one of the leading causes of preventable blindness worldwide [1]. It is an eye disease characterized by progressive damage to the optic nerve head and retinal nerve fiber layer (RNFL), and may be associated with elevated intraocular pressure in most cases, leading to increasing vision loss and, eventually, blindness [2]. Accumulating evidence suggests an association between glaucoma and Alzheimer’s disease (AD), as both conditions share similar epidemiology, such as increased prevalence in older ages [3], impairment of magnocellular visual processing [4], and pathophysiological features. Cohort studies showed that glaucoma patients have an increased risk for dementia [9], and dementia patients have an increased prevalence of glaucoma [10].
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