背景:大量证据支持青光眼和痴呆具有共同的病理机制和致病危险因素。然而,青光眼之间的联系,认知能力下降和痴呆尚未得到阐明.
目的:本研究旨在评估青光眼是否会增加痴呆或认知障碍的风险。
方法:PubMed,科克伦图书馆,WebofScience,从开始至2024年3月10日检索了队列或病例对照研究的EMBASE数据库.使用纽卡斯尔-渥太华质量评估量表(NOS)评估偏倚风险。使用I2检验严格评估异质性,而发表偏倚是通过漏斗图的目视检查和Egger回归不对称检验来评估的。应用亚组分析来确定异质性的来源。
结果:纳入了27项研究,涵盖9,061,675名个体。汇总分析表明,青光眼增加了全因痴呆的风险,老年痴呆症,血管性痴呆,和认知障碍。亚组分析显示,年龄≥65岁的痴呆患病率为2.90(95%CI:1.45-5.77),年龄<65岁的痴呆患病率为2.07(95%CI:1.18-3.62);女性青光眼患者的发病率为1.46(95%CI:1.06-2.00),分别,男性患者无统计学意义。在青光眼类型中,POAG更有可能发展为痴呆和认知障碍。地区分布也存在差异,在亚洲地区患病率最高,而在欧洲和北美地区,青光眼与痴呆无关。
结论:青光眼增加了随后的认知障碍和痴呆的风险。青光眼的类型,性别,年龄,研究人群的区域组成可能显著影响青光眼与痴呆的关系。
BACKGROUND: Substantial evidence supports that glaucoma and dementia share pathological mechanisms and pathogenic risk factors. However, the association between glaucoma, cognitive decline and dementia has yet to be elucidated.
OBJECTIVE: This study was aimed to assess whether glaucoma increase the risk of dementia or cognitive impairment.
METHODS: PubMed, Cochrane Library, Web of Science, and EMBASE databases for cohort or case-control studies were searched from inception to March 10, 2024. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used to the risk of bias. Heterogeneity was rigorously evaluated using the I2 test, while publication bias was assessed by visual inspection of the funnel plot and by Egger\' s regression asymmetry test. Subgroup analyses were applied to determine the sources of heterogeneity.
RESULTS: Twenty-seven studies covering 9,061,675 individuals were included. Pooled analyses indicated that glaucoma increased the risk of all-cause dementia, Alzheimer\'s disease, vascular dementia, and cognitive impairment. Subgroup analysis showed that the prevalence of dementia was 2.90 (95% CI: 1.45-5.77) in age ≥ 65 years and 2.07 (95% CI: 1.18-3.62) in age<65 years; the incidence rates in female glaucoma patients was 1.46 (95% CI: 1.06-2.00), respectively, which was no statistical significance in male patients. Among glaucoma types, POAG was more likely to develop dementia and cognitive impairment. There were also differences in regional distribution, with the highest prevalence in the Asia region, while glaucoma was not associated with dementia in Europe and North America regions.
CONCLUSIONS: Glaucoma increased the risk of subsequent cognitive impairment and dementia. The type of glaucoma, gender, age, and region composition of the study population may significantly affect the relationship between glaucoma and dementia.