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Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study.

TitleRetinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study.
Publication TypeJournal Article
Year of Publication2019
AuthorsDeal JA, Sharrett ARichey, Albert M, Bandeen-Roche K, Burgard S, Thomas SDavis, Gottesman RF, Knopman D, Mosley T, Klein B
Secondary AuthorsKlein R
JournalAlzheimers Dement
Volume15
Issue3
Pagination477-486
Date Published2019 03
ISSN1552-5279
KeywordsAfrican Americans, Aged, Atherosclerosis, Cognitive Dysfunction, Dementia, European Continental Ancestry Group, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Retinal Diseases, Retinal Vessels, Risk Factors
Abstract

INTRODUCTION: The easily-imaged retinal microvasculature may reflect the brain microvasculature and therefore be related to dementia.

METHODS: In a population-based study of 12,482 adults aged 50-73 years (22% African American), we estimated the relationship of retinal characteristics from fundus photography (1993-1995) with incident all-cause dementia (1993-1995 to 2011-2013) and with etiologic subtype of dementia/mild cognitive impairment (2011-13).

RESULTS: A total of 1259 (10%) participants developed dementia over a mean 15.6 years. Moderate/severe (vs. no) retinopathy (hazard ratio [HR], 1.86; 95% confidence interval [CI]: 1.36-2.55) and central retinal arteriolar equivalent (narrowest quartile vs. widest three quartiles; HR, 1.26; 95% CI: 1.09-1.45) were associated with all-cause dementia. Results were qualitatively stronger (but not statistically significantly different) in participants with diabetes. Retinopathy was associated with a joint outcome of cerebrovascular-related, but not Alzheimer's disease-related, dementia/mild cognitive impairment (HR, 2.29; 95% CI: 1.24-4.23).

DISCUSSION: Exploration of measures in the eye may provide surrogate indices of microvascular lesions relevant to dementia.
DOI10.1016/j.jalz.2018.10.002
Alternate JournalAlzheimers Dement
PubMed ID30439332
PubMed Central IDPMC6408967
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
K01 AG054693 / AG / NIA NIH HHS / United States
HHSN268201000021C / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States