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Prevalence of Retinal Signs and Association With Cognitive Status: The ARIC Neurocognitive Study.

TitlePrevalence of Retinal Signs and Association With Cognitive Status: The ARIC Neurocognitive Study.
Publication TypeJournal Article
Year of Publication2019
AuthorsLee MJeong, Deal JA, Ramulu PY, Sharrett ARichey
Secondary AuthorsAbraham AG
JournalJ Am Geriatr Soc
Volume67
Issue6
Pagination1197-1203
Date Published2019 06
ISSN1532-5415
KeywordsAged, Brain, Cerebrovascular Disorders, Cognition, Cognitive Dysfunction, Cohort Studies, Cross-Sectional Studies, Dementia, Female, Humans, Male, Retinal Vessels, Risk Factors
Abstract

OBJECTIVE: To determine the prevalence of retinal microvascular signs and associations between retinal signs and cognitive status.

DESIGN: Cross-sectional analysis of visit 5 (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) cohort. Data analysis took place November 30, 2017, to May 1, 2018.

SETTING: Biracial population-based cohort from four US communities.

PARTICIPANTS: A total of 2624 participants with a mean age of 76 years (SD = 5 years) (19% African American) with data on cognitive status and complete retinal examination.

MEASUREMENTS: Retinal signs measured with fundus photography. Cognitive status: normal cognition, mild cognitive impairment (MCI)/dementia with a primary diagnosis of Alzheimer disease (AD) without cerebrovascular disease (CVD), and MCI/dementia with a primary or secondary diagnosis of CVD (irrespective of AD).

RESULTS: Overall, 6% of the cohort had mild retinopathy and 2% had moderate/severe retinopathy. Of the cohort, 7% had microaneurysms, 6% had retinal hemorrhages, and 8% had arteriovenous (AV) nicking. There was a low prevalence of soft exudates (1%) and focal narrowing (1%). In weighted fully adjusted models, individuals with retinal hemorrhages had a two-fold higher odds of all-cause MCI/dementia (95% confidence interval [CI] = 1.3-3.0; P = .001) and a 2.5-fold higher odds (95% CI = 1.6-3.9; P

CONCLUSION: Our findings are confirmatory of recent research, and suggest that retinal microvascular signs may reflect microvascular pathology in the brain, potentially contributing to dementia and earlier MCI. The low prevalence of retinal signs and modest associations with cognitive status, however, limit the current clinical utility of these findings. Further work is needed to determine whether more sophisticated imaging may detect more subtle retinal signs with higher sensitivity to identify individuals at risk of dementia.

DOI10.1111/jgs.15795
Alternate JournalJ Am Geriatr Soc
PubMed ID30706941
PubMed Central IDPMC6698148
Grant ListU01 HL096917 / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
U01 HL096812 / HL / NHLBI NIH HHS / United States
R01 AG052412 / AG / NIA NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
K01 AG054693 / AG / NIA NIH HHS / United States