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Retinal microvascular abnormalities and cognitive decline: the ARIC 14-year follow-up study.

TitleRetinal microvascular abnormalities and cognitive decline: the ARIC 14-year follow-up study.
Publication TypeJournal Article
Year of Publication2009
AuthorsLesage SR, Mosley TH, Wong TY, Szklo M, Knopman D, Catellier DJ, Cole SR, Klein R, Coresh J, Coker LH, Sharrett AR
JournalNeurology
Volume73
Issue11
Pagination862-8
Date Published2009 Sep 15
ISSN1526-632X
KeywordsCardiovascular Diseases, Cognition Disorders, Female, Follow-Up Studies, Humans, Male, Microvessels, Middle Aged, Neuropsychological Tests, Odds Ratio, Prospective Studies, Retinal Vessels, Risk Factors
Abstract

BACKGROUND: Because retinal and cerebral arterioles share similar pathologic processes, retinal microvascular changes are expected to be markers of cerebral small vessel disease (SVD). To better understand the role of SVD in cognitive function, we investigated the relationship between retinal microvascular abnormalities and longitudinal changes in cognitive function in a community-based study.

METHODS: A total of 803 participants underwent 4 cognitive assessments between 1990-1992 and 2004-2006, using the Word Fluency (WF) test, Digit Symbol Substitution (DSS), and Delayed Word Recall as well as retinal photography in 1993-1995. Covariate adjusted random effects linear models for repeated measures were used to determine the associations of cognitive change with specific retinal vascular abnormalities.

RESULTS: Individuals with retinopathy showed declines in executive function and psychomotor speed, with 1) an average decline in WF of -1.64 words per decade (95% confidence interval [CI] -3.3, -0.02) compared to no decline in those without retinopathy +0.06 (95% CI -0.6, 0.8) and 2) a higher frequency of rapid decliners on the DSS test.

CONCLUSION: Signs of retinal vascular changes, as markers of the cerebral microvasculature, are associated with declines in executive function and psychomotor speed, adding to the growing evidence for the role of microvascular disease in cognitive decline in the elderly.

DOI10.1212/WNL.0b013e3181b78436
Alternate JournalNeurology
PubMed ID19752453
PubMed Central IDPMC2744282
Grant ListR03 EYO13939 / / PHS HHS / United States
R01 HL70825 / HL / NHLBI NIH HHS / United States
2 U10 EY006594-21A1 / EY / NEI NIH HHS / United States
R01-AG023195 / AG / NIA NIH HHS / United States
1 R01 DK073217-01 / DK / NIDDK NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
U01-HL-075572 / HL / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
P50-AG 16574 / AG / NIA NIH HHS / United States
U01 AG016976 / AG / NIA NIH HHS / United States
R01DK076770-01 / DK / NIDDK NIH HHS / United States
N01-AG-1-2100 / AG / NIA NIH HHS / United States
5U01DK067651 / DK / NIDDK NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
R01-AG11378 / AG / NIA NIH HHS / United States
R21 HL077166-01 / HL / NHLBI NIH HHS / United States
N01-WH-4-4221 / WH / WHI NIH HHS / United States
MM-0997-07/07 / / PHS HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
R01-HL70825 / HL / NHLBI NIH HHS / United States
1 R01 HL69979 / HL / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
T32HL007024 / HL / NHLBI NIH HHS / United States
1 R01 EY016379 / EY / NEI NIH HHS / United States
UL1-RR025005-01 / RR / NCRR NIH HHS / United States
N01HC95178 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
U01 AG 06786 / AG / NIA NIH HHS / United States
PA-07-070 / / PHS HHS / United States