Associations Between Glaucoma and All-cause Mortality in the Middle-Aged and Older Chinese Population: Results from the China Health and Retirement Longitudinal Study

Abstract Objective: To investigate the association between glaucoma and mortality in the older population.Design: Population-based, prospective cohort study.Participants: 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 of the participants was observed during seven years of follow-up.Methods: The baseline data were collected in the 2011 CHARLS, and participants were followed up for seven years (until 2018). The risk of all-cause mortality was examined using Cox proportional hazards regression with age as the time scale, adjusting for significant risk factors and comorbid conditions.Main outcome measures: Mortality, resulting from all causes.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]: 2.159, 95% confidence interval [CI]: 1.549-3.008). In a subgroup analysis based on the mean age of death, among those who were 75 years and older (n = 563), the risk of all-cause death was significantly higher in patients with glaucoma than in those without glaucoma (HR: 1.907, 95% CI: 1.249-2.911).Conclusions: Participants with glaucoma were at an increased risk for all-cause mortality, especially those participants aged 75 years and above. Our findings revealed possible underlying mechanisms creating the association between glaucoma and all-cause mortality, and they highlighted the importance of glaucoma management to prevent premature death in middle-aged and older adults.