|Title||Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study.|
|Publication Type||Journal Article|
|Year of Publication||2018|
|Authors||Deal JA, Sharrett ARichey, Rawlings AM, Gottesman RF, Bandeen-Roche K, Albert M, Knopman D, Selvin E, Wasserman BA, Klein B|
|Secondary Authors||Klein R|
|Date Published||2018 03 27|
|Keywords||Aged, Atherosclerosis, Cognitive Dysfunction, Diabetes Mellitus, Female, Fundus Oculi, Humans, Male, Middle Aged, Neuropsychological Tests, Prospective Studies, Retinal Diseases, Risk|
OBJECTIVE: To test the hypothesis that retinal vascular signs are associated with greater cognitive decline over 20 years in 12,317 men and women 50 to 73 years of age at baseline.
METHODS: A composite cognitive score was created with 3 neuropsychological tests measured at 3 time points (1990-1992 to 2011-2013). Retinal signs were measured with fundus photography (1993-1995). Differences in cognitive change by retinal signs status were estimated with linear mixed models. Cognitive scores were imputed for living participants with incomplete cognitive testing.
RESULTS: In multivariable-adjusted analyses that controlled for attrition, loss of vascular integrity (retinopathy and its components) was associated with greater 20-year decline (difference in 20-year cognitive change for moderate/severe vs no retinopathy -0.53 SD, 95% confidence interval -0.74 to -0.33). Estimated differences were similar in participants with and without diabetes mellitus and in white and black participants.
CONCLUSIONS: Retinopathy was associated with accelerated rates of 20-year cognitive decline. These findings support the exploration of more sensitive measures in the eye such as optical coherence tomography angiography, which may provide surrogate indexes of microvascular lesions relevant to cognitive decline in older adults.
|PubMed Central ID||PMC5880633|
|Grant List||U01 HL096812 / HL / NHLBI NIH HHS / United States |
U01 HL096917 / HL / NHLBI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
K24 AG052573 / AG / NIA NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
K01 AG054693 / AG / NIA NIH HHS / United States