Wills, Trusts & Estates Prof Blog

Editor: Gerry W. Beyer
Texas Tech Univ. School of Law

Wednesday, June 26, 2019

Can an Eye Exam Reveal Alzheimer’s Risk?

EyeA visit to the eye doctor could reveal clues to not only your vision health, but may also someday assist in analyzing the health of your brain. A recent study performed by the Harvard T.H. Chan School of Public Health shows links between many forms of eye conditions, such as glaucoma and diabetic retinopathy, to an increased risk of Alzheimer's and other forms of dementia. One eye condition that does not appear to be linked to Alzheimer's is cataracts, though it is also age-related.

“My view, and one of the possible explanations that the authors present, is that these three eye diseases and Alzheimer’s and dementia have a joined etiology (a common causative factor). All are linked to cardiovascular disease,” says Dr. Albert Hofman, chair of epidemiology. The study began in 1994 and involved 5,400 dementia-free adults, following them until they left the study, died, or developed a form of dementia. The study found that people with age-related macular degeneration were 20% more likely to develop dementia compared with people who did not have the eye condition. People with diabetic retinopathy were 44% more likely to develop dementia than those without, and those with a recent glaucoma diagnosis (not an established diagnosis) had a 44% higher rate of dementia.

Though eye exams today may not be able to tell a patient if they have Alzheimer's or dementia, the knowledge that this study brings could enable doctors to focus on preventive measures. “Doing all the things that you would do to prevent heart attack and stroke are likely beneficial to prevent Alzheimer’s disease,” says Dr. Hofman. This means treating high blood pressure and cholesterol, eating a healthy diet, getting enough sleep, and maintaining a regular exercise program.

See Kelly Bilodeau, Can an Eye Exam Reveal Alzheimer’s Risk?, Harvard.edu, June 7, 2019.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.

https://lawprofessors.typepad.com/trusts_estates_prof/2019/06/can-an-eye-exam-reveal-alzheimers-risk.html

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Comments

The study is here:

https://doi.org/10.1016/j.jalz.2018.06.2856

The article is not open access. So we have to trust the design of this observational study, and we can only discuss its claimed results:

"Over 31,142 person-years of follow-up, 792 AD cases occurred. The recent and established hazard ratio were 1.46 (P = .01) and 0.87 (P = .19) for glaucoma, 1.20 (P = .12) and 1.50 (P < .001) for AMD, and 1.50 (P = .045) and 1.50 (P = .03) for DR."

The studies only claims the existence of a correlation, but we have no idea what the force of the signal is.

Moreover, I wonder to which population they compared to claim increased risk. No information on that in the abstract.

Medical doctors should learn to use mathematics and statistics more rigorously, in my opinion.

Posted by: F68.10 | Jun 26, 2019 4:02:59 PM

Oh sorry. Looked only at the p-values and not the hazard ratios. I don't find them flabbergasting. Way too soon to conclude to a common etiology in my opinion.

Posted by: F68.10 | Jun 26, 2019 4:05:18 PM

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