Title | Retinal microvascular abnormalities and cognitive decline: the ARIC 14-year follow-up study. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Lesage SR, Mosley TH, Wong TY, Szklo M, Knopman D, Catellier DJ, Cole SR, Klein R, Coresh J, Coker LH, Sharrett AR |
Journal | Neurology |
Volume | 73 |
Issue | 11 |
Pagination | 862-8 |
Date Published | 2009 Sep 15 |
ISSN | 1526-632X |
Keywords | Cardiovascular 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. |
DOI | 10.1212/WNL.0b013e3181b78436 |
Alternate Journal | Neurology |
PubMed ID | 19752453 |
PubMed Central ID | PMC2744282 |
Grant List | 1 R01 DK073217-01 / DK / NIDDK NIH HHS / United States N01-HC-55022 / 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 R21 HL077166-01 / 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 R03 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 U01-HL-075572 / HL / NHLBI NIH HHS / United States N01-HC-55016 / HC / NHLBI NIH HHS / United States N01-AG-1-2100 / AG / NIA NIH HHS / United States R01-AG11378 / AG / NIA NIH HHS / United States 5U01DK067651 / DK / NIDDK NIH HHS / United States N01-HC-55021 / HC / 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 |