Pseudoexfoliation and Alzheimer's disease: a population-based 30-year follow-up study

Purpose: To determine the effect of pseudoexfoliation (PEX) on the development of Alzheimer's disease (AD) in a population in which PEX is a common finding. The relationship between open-angle glaucoma (OAG) and AD was also studied. Methods: Predictors of incident AD, including mixed and unspecified dementia, were analysed in a cohort of 679 residents 65-74years of age, examined in a population survey in the municipality of Tierp, Sweden, 1984-1986. To expand the cohort, participants in other studies in Tierp were enrolled. In this way, the cohort embraced 1123 people, representing more than 15700 person-years at risk. Medical records were reviewed to identify subjects diagnosed with dementia. Those with a follow-up time shorter than 2years were excluded from the study. Results: By the conclusion of the study, in December 2011, 174 new cases of AD, including mixed and unspecified dementia, had been detected, 41 of whom were affected by PEX at baseline. Higher age and female gender were the only predictors identified. No association between PEX and AD was found (hazard ratio 0.98; 95% confidence interval 0.69-1.40). Newly diagnosed OAG at baseline did not increase the risk (hazard ratio 1.09; 95% confidence interval 0.69-1.74). Conclusion: Pseudoexfoliation is not a predictor of AD. No association was found between OAG and AD.