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Mengqiao Xu 1 Article
The association between glaucoma and all-cause mortality in middle-aged and elderly Chinese people: results from the China Health and Retirement Longitudinal Study
Xiaoxu Huang, Mengqiao Xu, Minwen Zhou, Wenjia Liu, Xiaohuan Zhao, Xiaodong Sun
Epidemiol Health. 2023;45:e2023066.   Published online July 21, 2023
DOI: https://doi.org/10.4178/epih.e2023066
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Abstract
OBJECTIVES
This population-based, prospective cohort study investigated the association between glaucoma and mortality in older adults.
METHODS
Participants aged 45 years or older at baseline (47.9% male) were enrolled in 2011 for the China Health and Retirement Longitudinal Study (CHARLS). All-cause mortality was observed during 7 years of follow-up. The baseline data were collected in the 2011 CHARLS, and participants were followed up for 7 years (until 2018). The risk of all-cause mortality was investigated using Cox proportional-hazards regression with age as the time scale, adjusting for significant risk factors and comorbid conditions.
RESULTS
Among the 14,803 participants included, the risk of all-cause death was significantly higher among people with glaucoma than among those without glaucoma, after adjustment for other confounders (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.04 to 2.03). In a subgroup analysis based on the mean age of death, among those who were 75 years and older (n=1,231), the risk of all-cause death was significantly higher in patients with glaucoma than in those without glaucoma (HR, 1.89; 95% CI, 1.24 to 1.89).
CONCLUSIONS
Participants with glaucoma had a higher risk of all-cause mortality, especially those aged 75 years and above. Our findings revealed potential mechanisms underlying an association between glaucoma and all-cause mortality. They also highlighted the importance of glaucoma management to prevent premature death in middle-aged and older adults.
Summary
Key Message
The present study suggests that glaucoma is associated with a higher rate of mortality in middle-aged and elderly people in China, especially for those aged 75 years and older. This study provides an important reference for the design and evaluation of clinical glaucoma treatment and the management of patients of different ages.

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