Ki Young Son, Yong-Jun Choi, Bongseong Kim, Kyungdo Han, Sungsoon Hwang, Wonyoung Jung, Dong Wook Shin, Dong Hui Lim
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Participants with VD were defined as those registered in a national disability registration established by the Korean government. The prospective association of AMD and related VD with new-onset dementia was investigated using a multivariate-adjusted Cox proportional hazard model adjusted for age, sex, body mass index, income level, systemic comorbidities, psychiatric diseases, and behavioral factors.</p><p><strong>Results: </strong>During the average follow-up period of 9.7 ± 2.16 years, 4260 of 21,384 participants in the AMD cohort and 137,166 of 1,662,319 participants in the control cohort were newly diagnosed with dementia, respectively. Participants diagnosed with AMD showed a higher risk of new-onset dementia than those in the control group in the fully adjusted model [hazard ratio (HR) 1.11, 95% CI 1.07-1.14]. 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引用次数: 0
摘要
目的：研究相关视力障碍（VD）患者痴呆风险与年龄相关性黄斑变性（AMD）之间的前瞻性关联。设计：一项基于全国人群的队列研究，使用韩国国民健康保险服务机构提供的授权数据。环境和参与者：共有1,788,457名年龄在100至50岁之间的人参加了韩国国家健康筛查计划。方法：从2009年1月到2019年12月，使用来自索赔数据的注册诊断代码跟踪参与者的痴呆症诊断。VD患者被定义为在韩国政府设立的国家残疾登记中登记的人。采用多变量校正Cox比例风险模型，对年龄、性别、体重指数、收入水平、全身合并症、精神疾病和行为因素进行校正，研究AMD和相关VD与新发痴呆的前瞻性关联。结果：在平均9.7±2.16年的随访期间，AMD组21384名参与者中有4260名新诊断为痴呆，对照组1662319名参与者中有137166名新诊断为痴呆。在完全调整模型中，被诊断为AMD的参与者患新发痴呆的风险高于对照组[风险比（HR） 1.11, 95% CI 1.07-1.14]。诊断为AMD和相关VD的参与者患痴呆的风险（HR 1.28, 95% CI 1.15-1.43）高于无VD的参与者（HR 1.09, 95% CI 1.06-1.13）。结论和意义：AMD的诊断与全因痴呆及其主要亚型的风险增加有关。密切监测AMD患者的认知功能，特别是伴有VD的患者，可能有助于早期发现全因痴呆，从而减轻患者的社会经济负担，提高患者的生活质量。
Association between Age-Related Macular Degeneration with Visual Disability and Risk of Dementia: A Nationwide Cohort Study.
Objectives: To investigate the prospective association between the risk of dementia and age-related macular degeneration (AMD) in patients with related visual disability (VD).
Design: A nationwide population-based cohort study used authorized data provided by the Korean National Health Insurance Service.
Setting and participants: A total of 1,788,457 individuals aged >50 years who participated in the Korean National Health Screening Program were enrolled.
Methods: From January 2009 to December 2019, participants were tracked for a diagnosis of dementia using registered diagnostic codes from claims data. Participants with VD were defined as those registered in a national disability registration established by the Korean government. The prospective association of AMD and related VD with new-onset dementia was investigated using a multivariate-adjusted Cox proportional hazard model adjusted for age, sex, body mass index, income level, systemic comorbidities, psychiatric diseases, and behavioral factors.
Results: During the average follow-up period of 9.7 ± 2.16 years, 4260 of 21,384 participants in the AMD cohort and 137,166 of 1,662,319 participants in the control cohort were newly diagnosed with dementia, respectively. Participants diagnosed with AMD showed a higher risk of new-onset dementia than those in the control group in the fully adjusted model [hazard ratio (HR) 1.11, 95% CI 1.07-1.14]. The risk of dementia was higher in participants diagnosed with AMD and associated VD (HR 1.28, 95% CI 1.15-1.43) compared to those without VD (HR 1.09, 95% CI 1.06-1.13).
Conclusions and implications: A diagnosis of AMD was associated with an increased risk of all-cause dementia and its major subtypes. Close monitoring of cognitive function in patients with AMD, especially those with VD, may help in early detection of all-cause dementia, which could reduce the socioeconomic burden and improve the quality of life of patients.
期刊介绍：
JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates.
The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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