Abstract
BACKGROUND: Our limited understanding of dementia's complex pathogenesis confines treatment options primarily to symptom management rather than targeting underlying disease processes, underscoring the need for innovative treatment and preventive strategies. This study aimed to examine the relationship between optic neuritis (ON), an autoimmune inflammatory condition of the optic nerve, and the risk of developing dementia. METHODS: This nationwide, population-based cohort study was conducted in Korea, analyzing a cohort of 15,286 ON patients newly diagnosed between 2010 and 2017 who were age and sex matched against 76,430 controls without ON. Primary outcomes were incident cases of Alzheimer's disease, vascular dementia, or other types of dementia. Cox proportional hazards regression models were employed to assess the association between ON and dementia risk after adjusting for demographic characteristics, lifestyle factors, and other comorbidities. Dementia risk was assessed through hazard ratios (HRs), with an average follow-up period of 3.06 years. RESULTS: ON patients shows greater risks of all-cause dementia (HR: 1.258) and Alzheimer's disease (HR: 1.264). Associations between ON and dementia are prominent in younger patients and current smokers. CONCLUSION: This research suggests that autoimmunity, particularly in the form of ON, may significantly contribute to dementia development. This study implies that younger ON patients who smoke could be at a high risk of developing dementia, emphasizing the need for preventative strategies and additional research to establish causality. This work broadens the scope of known dementia risk factors and opens new avenues for research into autoimmune mechanisms as targets for therapeutic intervention.