Cataract surgery is associated with reduced risk for Alzheimer’s disease
Year: 2020
Type: article
Study design: Observational Study
Abstract: Background Visual improvement after cataract surgery is well‐established, but the literature on the potential impact of cataract surgery on Alzheimer’s disease (AD) is conflicting. Using data from a large, well‐characterized cohort, we sought to determine whether cataract surgery was associated with lower risk of developing AD. Method The Adult Changes in Thought (ACT) study is a 25‐year‐old ongoing population‐based study of participants recruited from Kaiser Permanente Washington (KPW) membership rolls, aged ≥ 65 without dementia at enrollment and followed until dementia or death. AD was diagnosed using established research criteria. Extensive clinical data were obtained during study visits and via KPW electronic medical records (EMR). Eye‐related diagnoses and procedures were based on ICD‐9/10 and CPT codes. We used Cox proportional hazard regression modeling for probable or possible AD. Because healthier participants might have been more likely to receive surgery, we built marginal structural models accounting for several health and cognitive factors as one of several secondary analyses. We also examined the associations between AD and glaucoma surgery as a comparator procedure. Result A total of 3,719 participants with cataract diagnosis were included, with 840 incident AD cases. 1,815 (49%) underwent cataract surgery and 1,914 did not (Table 1). The adjusted HR of developing AD in people who underwent cataract surgery was 22% lower than those who did not undergo cataract surgery (HR=0.78, [95%CI 0.68, 0.91], p=0.001), and the effect was stronger for recent surgery (Table 2; Figure). Secondary analyses to account for healthy patient bias yielded similar results, as did omitting the original cohort with a shorter EMR history, or just considering cataract diagnosis after baseline. Ignoring cataract surgery 2 years prior to AD yielded stronger effect. Glaucoma surgery was not associated with AD. Conclusion Cataract surgery is associated with lower risk of AD in this prospective, population‐based study. This finding does not appear to be due to healthier participants receiving surgery. Further research on the implications of eye conditions and treatments on Alzheimer’s disease is warranted.
Source: Alzheimer s & Dementia
DOI: 10.1002/alz.044940
Authors: Cecilia S Lee, Laura E Gibbons, Michael L Lee, Aaron Y Lee, Ryan T Yanagihara, Paul K Crane, Eric B Larson
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3087966141
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