Risk of Subsequent Dementia or Alzheimer Disease Among Patients With Age-Related Macular Degeneration: A Systematic Review and Meta-analysis

center dot PURPOSE: Alzheimer disease (AD), a common form of dementia, shares several clinical and pathologic features with age-related macular degeneration (AMD). Epidemi-ologic reports on the association of AMD with subsequent dementia or AD are inconsistent.center dot DESIGN: Systematic review and meta-analysis.center dot METHODS: The Meta-analysis of Observational Studies in Epidemiology reporting guidelines were applied. The Newcastle-Ottawa Scale was used to evaluate the risk of bias in the included cohort studies that examined the as-sociation of AMD with subsequent dementia or AD. We estimated the pooled hazard ratios (HRs) of dementia or AD using random effects model meta-analysis and sub-group analysis on different follow-up periods, AMD sub-type, gender, age, study design, and methods to ascertain dementia or AD.center dot RESULTS: A total of 8 223 581 participants were in-cluded in 8 studies published during 2000-2021. The meta-analysis showed that AMD was significantly associ-ated with subsequent dementia (pooled HR 1.22, 95% CI 1.01-1.47) or AD (pooled HR 1.21, 95% CI 1.03-1.43). Our secondary analysis revealed that the association was more noticeable in dry AMD than wet AMD.center dot CONCLUSIONS: Patients with AMD have higher risks of developing dementia or AD, and therefore identifying related comorbidities and retinal biomarkers is much war-ranted for older adults with AMD in ophthalmologic prac-tice. (Am J Ophthalmol 2023;247: 161-169.(c) 2022 Published by Elsevier Inc.)

Automated summary

This systematic review and meta-analysis found a significant association between age-related macular degeneration (AMD) and the subsequent development of dementia or Alzheimer's disease (AD). The risk was higher in patients with dry AMD compared to wet AMD. These findings emphasize the importance of identifying comorbidities and retinal biomarkers in older adults with AMD in ophthalmologic practice.