The association between antiglaucomatous agents and Alzheimer’s disease

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The association between antiglaucomatous agents and Alzheimer's disease

Objectives: To estimate the risk of Alzheimer's disease (AD) associated with long-term use of topical glaucoma medications among middle-aged and older glaucoma patients, and compare the AD risk among various glaucoma subtypes.

Methods: This nationwide population-based cohort study utilized insurance claims data from Taiwan's National Health Insurance Research Database between 2008 and 2019. Participants were adults aged 45 years or older either with a diagnosis of glaucoma or without. Those with glaucoma must have received single antiglaucomatous medication (including α2-adrenergic agonists, cholinergic agonists, beta-blockers, prostaglandin analogs, and pilocarpine) for over 90 days. Those with pre-existing AD diagnoses prior to the index date were excluded.

Results: A total of 202,000 participants were included in the study, with 101,000 in each group (glaucoma and control groups). Glaucoma patients on topical alpha-2 adr energic agonist monotherapy exhibited a significantly higher AD risk (aHR 1.15, 95% CI = 1.01–1.31) compared to those on beta-blockers. Glaucoma was further categorized into primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), primary angle-closure glaucoma (PACG), and unspecified glaucoma. Irrespective of the type of glaucoma, individuals with glaucoma had a significantly higher risk of AD compared to those without glaucoma (POAG: aHR 1.23, 95% CI = 1.08–1.40; NTG: aHR 1.49, 95% CI = 1.19–1.85; PACG: aHR 1.35, 95% CI = 1.19–1.52; unspecified glaucoma: aHR 1.36, 95% CI = 1.23–1.50). Conclusions: Topical alpha-2 adrenergic agonists might pose increased AD risk in individuals with glaucoma compared to beta-blockers. Accordingly, their utilization should be undertaken judiciously, especially in middle-aged and older populations. Our findings also indicate glaucoma may increase the risk of AD regardless of glaucoma subtype. © The Author(s), under exclusive licen ce to The Royal College of Ophthalmologists 2024.

Authors : Chou C.-C.; Lu Y.-A.; Weng C.-H.; Lin H.-J.; Wang I.-J.; Jou T.-S.; Wang C.-Y.; Tsai F.-J.; Cheng Y.-D.; Hsu T.-J.; Hung Y.-T.; Huang Y.-H.; Tien P.-T.

Source : Springer Nature