TY - JOUR
T1 - Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study
AU - Deal, Jennifer A.
AU - Sharrett, Albert Richey
AU - Albert, Marilyn
AU - Bandeen-Roche, Karen
AU - Burgard, Sheila
AU - Thomas, Sonia Davis
AU - Gottesman, Rebecca F.
AU - Knopman, David
AU - Mosley, Thomas
AU - Klein, Barbara
AU - Klein, Ronald
N1 - Publisher Copyright:
© 2018 the Alzheimer's Association
PY - 2019/3
Y1 - 2019/3
N2 - 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.
AB - 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.
KW - Cohort studies
KW - Dementia
KW - Diabetes
KW - Microvasculature
KW - Retinal
KW - Risk factors in epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85057455142&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85057455142&partnerID=8YFLogxK
U2 - 10.1016/j.jalz.2018.10.002
DO - 10.1016/j.jalz.2018.10.002
M3 - Article
C2 - 30439332
AN - SCOPUS:85057455142
SN - 1552-5260
VL - 15
SP - 477
EP - 486
JO - Alzheimer's and Dementia
JF - Alzheimer's and Dementia
IS - 3
ER -