Tsai Hou-Ren, Lo Raymond Y, Liang Kai-Hsiang, Chen Tai-Li, Huang Huei-Kai, Wang Jen-Hung, Lee Yuan-Chieh
From the Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (H.-R.T., Y.-C.L.), Hualien.
Division of Cognitive/Geriatric Neurology, Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University (R.Y.L.), Hualien; Institute of Medical Sciences, Tzu Chi University (R.Y.L.), Hualien.
Am J Ophthalmol. 2023 Mar;247:161-169. doi: 10.1016/j.ajo.2022.11.005. Epub 2022 Nov 12.
Alzheimer disease (AD), a common form of dementia, shares several clinical and pathologic features with age-related macular degeneration (AMD). Epidemiologic reports on the association of AMD with subsequent dementia or AD are inconsistent.
Systematic review and meta-analysis.
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 association 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 subgroup analysis on different follow-up periods, AMD subtype, gender, age, study design, and methods to ascertain dementia or AD.
A total of 8 223 581 participants were included in 8 studies published during 2000-2021. The meta-analysis showed that AMD was significantly associated 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.
Patients with AMD have higher risks of developing dementia or AD, and therefore identifying related comorbidities and retinal biomarkers is much warranted for older adults with AMD in ophthalmologic practice.
阿尔茨海默病（AD）是一种常见的痴呆形式，与年龄相关性黄斑变性（AMD）具有若干临床和病理特征。关于AMD与后续痴呆或AD关联的流行病学报告并不一致。
系统评价和荟萃分析。
应用流行病学观察性研究的荟萃分析报告指南。采用纽卡斯尔-渥太华量表评估纳入的队列研究中AMD与后续痴呆或AD关联的偏倚风险。我们使用随机效应模型荟萃分析和不同随访期、AMD亚型、性别、年龄、研究设计以及痴呆或AD确诊方法的亚组分析，估计痴呆或AD的合并风险比（HR）。
2000年至2021年发表的8项研究共纳入8223581名参与者。荟萃分析表明，AMD与后续痴呆（合并HR 1.22，95%CI 1.01-1.47）或AD（合并HR 1.21，95%CI 1.03-1.43）显著相关。我们的二次分析显示，干性AMD中的关联比湿性AMD更明显。
AMD患者发生痴呆或AD的风险更高，因此在眼科实践中，对于患有AMD的老年人，识别相关合并症和视网膜生物标志物非常有必要。
