Precis: This cross-sectional study of 172 patients with glaucoma showed that functional and structural glaucoma damage was significantly associated with cognitive impairment independent of age and visual acuity.
Purpose: The aim of this study was to determine whether functional and structural glaucoma damage is associated with cognitive function.
Patients and methods: This was a cross-sectional analysis comprising 172 patients with glaucoma with a mean age of 70.6 years. Functional glaucoma severity was evaluated according to the visual field mean deviation (MD) (severe, MD ≤-12 dB; mild, MD >-12 dB), and structural glaucoma severity was determined based on circumpapillary retinal nerve fiber layer thickness. The main outcome measure was cognitive impairment defined by a Mini-Mental State Examination (MMSE) score of ≤26 and MMSE-blind score of ≤16.
Results: The prevalence of patients with cognitive impairment (MMSE score ≤26) was significantly higher in the severe glaucoma group than in the mild glaucoma group (33.3% vs. 15.7%; P=0.010, respectively). Similar results were obtained in the analyses with MMSE-blind score of ≤16 (14.7% vs. 1.4%; P=0.003, respectively). Multivariable logistic regression analysis adjusted for potential confounders, including age, body mass index, education, visual acuity, hypertension, diabetes, and depressive symptoms, indicated a higher odds ratio (OR) for cognitive impairment (MMSE score ≤26) in patients with severe glaucoma than in those with mild glaucoma (OR, 2.62; 95% confidence interval, 1.006-6.84; P=0.049) and in relation to a 10-μm thinning of the retinal nerve fiber layer (OR, 1.42; 95% confidence interval, 1.05-1.93; P=0.025).
Conclusion: Functional and structural glaucoma damage was significantly associated with lower cognitive function independent of age and visual acuity in a glaucoma cohort.
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