Association of Age-Related Macular Degeneration and Dementia: A Health Registry Database Study

Objectives: Dementia and age-related macular degeneration (AMD) share common neurodegenerative risk factors. We examined the association between AMD and dementia. Methods and Analysis: This was a retrospective cohort study using an aggregated electronic health records network. Patients with AMD were matched 1:1 to pseudophakic controls without AMD or prior dementia using propensity score matching (PSM) for demographics and comorbidities. Outcomes included the development of Alzheimer’s disease (AD), Parkinson’s disease (PD), vascular dementia, and unspecified dementia, compared using relative risk (RR). Results: After PSM, 64,160 patients were included in each cohort. Rates of AD (1.19% vs. 1.19%, p = 0.92 at 5 years; 1.28% vs. 1.24%, p = 0.50 at 10 years), PD (0.54% vs. 0.52%, p = 0.76; 0.57% vs. 0.55%, p = 0.55), and vascular dementia (0.60% vs. 0.54%, p = 0.15; 0.65% vs. 0.57%, p = 0.08) were similar between cohorts. A modest increase in unspecified dementia was observed in the AMD cohort at 5 (3.07% vs. 2.84%, p = 0.02) and 10 years (3.30% vs. 3.01%, p < 0.01). Conclusions: Utilizing a large healthcare database, AMD was not associated with development of AD, PD, or vascular dementia compared to a matched pseudophakic control population. A small increase in unspecified dementia and aggregate neurodegenerative outcomes was observed in the AMD cohort; however, given the nonspecific nature of this diagnosis, this finding requires cautious interpretation. Further prospective studies are necessary to definitively establish a relationship between AMD and dementia.