Macular degeneration and Alzheimer's
A team of medical doctors from the Erasmus University Medical School has released
the results of a major study into a possible connection between age-related macular
degeneration and Alzheimer's disease. Macular degeneration (age-related maculopathy) and
Alzheimer's disease are both chronic neurodegenerative disorders, which are
characterized by extracellular plaque deposits either in the macula of the retina or in the
brain. Both disorders are more prevalent among smokers and people with
atherosclerosis. Their study involved 1438 Dutch men and women
aged 75 years or older. The participants underwent a thorough medical and
ophthalmologic examination and were screened for signs of dementia at the beginning of
the study and after two years of follow-up.
At baseline, 43.6 per cent of the participants were diagnosed with age-related
maculopathy of varying severity; none had signs of Alzheimer's disease at this stage. Two
years later, 62 of the participants had developed Alzheimer's disease. This corresponds
to an incidence rate of 14 per 1000 person-years in the 75 to 84 year age group and 41.6
per 1000 person-years in those aged 85 years or older. The researchers discovered a
clear relationship between the presence of moderate to severe (stage 3 and 4)
maculopathy at baseline and the incidence of Alzheimer's disease two years later. The
incidence of Alzheimer's was found to be twice as high among participants with moderate
to severe maculopathy as among participants with no or less severe maculopathy. The
risk factor was reduced to 1.5 (a 50 per cent excess risk) when the data was adjusted for
age, gender, smoking, and atherosclerosis.
The researchers conclude that macular degeneration and Alzheimer's disease may have a
common origin and that both diseases may be causally linked to smoking and
atherosclerosis.
Klaver, Caroline C.W., et al. Is age-related maculopathy associated with Alzheimer's
disease? American Journal of Epidemiology, Vol. 150, November 1, 1999, pp. 963-
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