Association of Ophthalmic and Systemic Conditions with Dementia Risk

Pavankumar Kamat


September 23, 2021


  • Ophthalmic conditions, including age-related macular degeneration (AMD), cataract and diabetes-related eye disease (DRED), but not glaucoma, were associated with an increased risk of incident dementia.

  • Individuals with both ophthalmic and systemic conditions had a higher risk of dementia compared with those with an ophthalmic or systemic condition alone.

Why this matters

  • Findings suggest that older adults with both ophthalmic and systemic conditions should be targeted for the prevention and screening of dementia.

Study design

  • The study included 12,364 participants (age, 55-73 years) from the UK Biobank, assessed at baseline between 2006 and 2010 and followed up until early 2021.

  • Funding: Fundamental Research Funds of the State Key Laboratory of Ophthalmology and others.

Key results

  • Over 1,263,513 person-years of follow-up, 2304 new cases of incident all-cause dementia, 945 new cases of Alzheimer’s disease and 513 new cases of vascular dementia were reported.

  • The risk of all-cause dementia increased with (adjusted HR [aHR]; 95% CI):

    • AMD (1.26; 1.05-1.52);

    • cataract (1.11; 1.00-1.24);

    • DRED (1.61; 1.30-2.00); and

  • Glaucoma had no significant association with incident all-cause dementia.

  • Among combinations of AMD and a systemic condition, AMD and diabetes together were associated with a higher risk of incident dementia (aHR, 2.73; 95% CI, 1.79-4.17).

  • The risk of incident dementia increased with:

    • cataract and a comorbidity such as (aHR; 95% CI):

      • stroke (2.00; 1.40-2.84);

      • heart disease (1.77; 1.43-2.21);

      • obesity (1.19; 0.95-1.48);

      • hypertension (1.36; 1.17-1.58);

      • diabetes (2.19; 1.78-2.70);

      • depression (2.29; 1.74-3.01); and

      • any systematic condition (1.57; 1.36-1.81).

    • DRED and a comorbidity such as (aHR; 95% CI):

      • stroke (2.29; 1.18-4.46);

      • heart disease (3.24; 2.18-4.81);

      • obesity (2.29; 1.36-3.84);

      • hypertension (1.50; 1.02-2.21);

      • depression (1.84; 0.85-4.01); and

      • any systematic condition (1.91; 1.16-3.14).


  • Ophthalmic conditions were defined as per self-reported and inpatient record data, which could lead to misclassification errors.


Shang X, Zhu Z, Huang Y, Zhang X, Wang W, Shi D, Jiang Y, Yang X, He M. Associations of ophthalmic and systemic conditions with incident dementia in the UK Biobank. Br J Ophthalmol. 2021 Sep 13 [Epub ahead of print]. doi: 10.1136/bjophthalmol-2021-319508. PMID: 34518160.  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: