What question did this study set out to answer?

To investigate the association between vitamin D deficiency and the 5-year incidence of dementia in glaucoma patients using electronic health records.

February 13, 2026Open Access

Increased risk of incident dementia associated with vitamin D deficiency in glaucoma patients: a TriNetX cohort study

YCYu-Chen ChengFu Jen Catholic University CLChien-Lin LuFu Jen Catholic University JWJoshua WangQueensland University of Technology

Key Points

To investigate the association between vitamin D deficiency and the 5-year incidence of dementia in glaucoma patients using electronic health records.
Retrospective cohort study utilizing electronic health records
Propensity score matching to create equal cohorts of vitamin D deficient and adequate patients (10,881 each)
Analysis of 5-year incidence of unspecified dementia, Alzheimer disease, and Parkinson disease using Cox proportional hazards models
Vitamin D deficiency associated with a higher 5-year risk of unspecified dementia (HR 1.241)
Severe vitamin D deficiency (<20 ng/mL) linked to even greater risk (HR 1.493)
No significant association found between vitamin D deficiency and Alzheimer disease or Parkinson disease
Major risk factors included advanced age, hypertension, and diabetes
Removing long-term NSAID users reduced dementia risk to non-significant levels

Abstract

Introduction Glaucoma is a progressive optic neuropathy associated with increased neurodegenerative risk. Vitamin D Deficiency (VDD) is a widespread systemic factor linked to neurobiological dysfunction. This study investigated the longitudinal association between VDD and the 5-year incidence of neurodegenerative outcomes in this glaucoma population. Methods This retrospective cohort study used a large electronic health records (EHRs) network. Glaucoma patients were classified as VDD ( 30 ng/mL) or vitamin D adequate (VDA) (≥30 ng/mL). A 1:1 propensity score matching (PSM) procedure matched 10,881 patients per cohort based on 47 covariates. The primary endpoints were the 5-year incidence of unspecified dementia, Alzheimer disease (AD), and Parkinson disease (PD), analyzed using Cox proportional hazards models. Results After PSM, VDD was associated with a higher 5-year risk of unspecified dementia (HR 1.241, 95% CI 1.066–1.446; p = 0.005), with greater risk in severe deficiency ( 20 ng/mL) (HR 1.493, 95% CI 1.179–1.890; p 0.001). No association was found between VDD and AD or PD. Major predictors included advanced age (HR 6.84), hypertension (HR 2.70), hypoalbuminemia (HR 2.64), elevated CRP (HR 1.38), and diabetes (HR 1.29). Removing long-term NSAID users reduced the dementia risk to non-significant levels (HR 1.178, 95% CI: 0.998–1.391, p = 0.053), suggesting NSAID anti-inflammatory effects may not counteract VDD-related dementia risk in glaucoma patients. Conclusion VDD is significantly associated with an increased risk of developing dementia in patients with glaucoma. These time-dependent and dose-response findings raise the possibility that correcting vitamin D deficiency may influence neurodegenerative outcomes, additional prospective studies are required to establish causality and clarify clinical implications.

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