Longitudinal Assessment of Age-Related Macular Degeneration and Risk of Dementia Using Clinical Setting Data.

Objective: To examine whether there is an association between age-related macular degeneration (AMD) and dementia using a large, multi-institutional clinical data. Design: A retrospective cohort study. Participants: Patients with AMD, including both neovascular AMD (nvAMD) and non-neovascular AMD (non-nvAMD) types, along with matched controls who had a record of eye examination but no diagnosis of AMD. Methods: Data were extracted from the 3 largest TriNetX networks (Global, United States, and Europe, Middle East, and Africa [EMEA]). Dementia diagnoses (Alzheimer disease [AD], vascular dementia, and unspecified dementia) and dementia-related medication use were compared between AMD and non-AMD groups. Diagnoses were identified using International Classification of Diseases, 10th Revision codes. Survival analyses were performed using Kaplan-Meier curves, and hazard ratios (HRs) were estimated using Cox proportional hazards models across 5-, 7-, and 10-year follow-up periods. Main Outcome Measures: Hazard ratios for dementia subtypes in AMD patients versus non-AMD patients and in nvAMD patients versus non-nvAMD patients. Results: No significant association between AMD and AD was observed in the global network. In the United States, AMD was associated with a reduced risk of AD at 5 and 7 years (HR = 0.79 and 0.75; Conclusions: Age-related macular degeneration was not consistently positively associated with AD or vascular dementia across networks. Regional variation, particularly negative associations in the United States, suggests underlying health care or diagnostic differences. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.