Associations Between Physical Activity and Glaucoma: Analysis of the National Institutes of Health All of Us Research Program

Précis: No association between physical activity as measured by Fitbit and primary open angle glaucoma diagnosis was observed among adult participants in the All of Us Research Program. Purpose: To investigate the associations between physical activity and glaucoma diagnosis in the United States. Patients and Methods: All subjects were adult participants in the National Institutes of Health All of Us Research Program. We defined a case cohort consisting of participants with Fitbit and electronic health record data with a diagnosis of primary open angle glaucoma (n=266). A control cohort consisted of participants with Fitbit and electronic health record data without primary open angle glaucoma diagnoses (n=7954). Descriptive analyses were performed on glaucoma and non-glaucoma cohorts’ demographics including age, gender, race, ethnicity, Charlson Comorbidity Index, and ophthalmic and systemic beta-blocker prescriptions. Univariable and multivariable logistic regression adjusted for demographic factors, Charlson Comorbidity Index, and ophthalmic and systemic beta-blocker prescriptions was conducted for association between odds of glaucoma diagnosis and each physical activity metric. Age-stratified sub-analyses for patients older than 40 and older than 65 were performed. Results: Participants in the glaucoma cohort had a significantly lower step count (6673 vs. 6891, P =0.04) and lower lightly active minutes (180 vs. 193, P <0.001). Step count and lightly active minutes did not remain significant in multivariable models, and all other activity metrics were not significant in multivariable models. These results were recapitulated in age-stratified analyses. Conclusions: There were no definitive associations between physical activity and primary open angle glaucoma diagnosis among All of Us participants, which was replicated among age-stratified subgroup analyses.