Association between cognitive performance and self-reported glaucoma in middle-aged and older adults: a cross-sectional analysis of ELSA-Brasil

Recent evidence suggests that glaucoma and Alzheimer's disease are neurodegenerative diseases sharing common pathophysiological and etiological features, although findings are inconclusive. We sought to investigate whether self-reported glaucoma patients without dementia present poorer cognitive performance, an issue that has been less investigated. We employed cross-sectional data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) and included participants ≥50 years of age without a known diagnosis of dementia and a self-reported glaucoma diagnosis. We excluded those with previous stroke, other eye conditions, and using drugs that could impair cognition. We evaluated cognition using delayed word recall, phonemic verbal fluency, and trail making (version B) tests. We used multinomial linear regression models to investigate associations between self-reported glaucoma with cognition, adjusted by several sociodemographic and clinical variables. Out of 4,331 participants, 139 reported glaucoma. Fully-adjusted models showed that self-reported glaucoma patients presented poorer performance in the verbal fluency test (β=-0.39, 95%CI=-0.64 to -0.14, P=0.002), but not in the other cognitive assessments. Thus, our results support the hypothesis that self-reported glaucoma is associated with poor cognitive performance; however, longitudinal data are necessary to corroborate our findings.

近期已有研究证据显示，青光眼（glaucoma）与阿尔茨海默病（Alzheimer's disease）同属神经退行性疾病，二者共享共同的病理生理与病因学特征，但目前相关研究结果尚不明确。本研究旨在探究无痴呆诊断的自我报告青光眼患者是否存在更差的认知表现——这一议题尚未得到充分探索。本研究使用巴西成人健康纵向研究（Brazilian Longitudinal Study of Adult Health, ELSA-Brasil）的横断面数据，纳入年龄≥50岁、无已知痴呆诊断且自我报告确诊青光眼的参与者。我们排除了曾罹患脑卒中、合并其他眼部疾病以及服用可能损害认知功能药物的受试者。采用延迟词语回忆测验、语音言语流畅性测验以及连线测验（B版）对认知功能进行评估。通过多项线性回归模型，在校正多项社会人口学与临床变量后，分析自我报告青光眼与认知表现之间的关联。在4331名研究参与者中，共有139名自我报告确诊青光眼。经完全校正的模型结果显示，自我报告青光眼患者在语音言语流畅性测验中表现显著更差（β=-0.39，95%置信区间：-0.64~-0.14，P=0.002），但在其余认知评估中未观察到显著差异。综上，本研究结果支持“自我报告青光眼与较差认知表现相关”这一假说，但仍需纵向研究数据来验证本研究的发现。