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Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study
Author(s) -
Deal Jennifer A.,
Sharrett A. Richey,
Albert Marilyn,
BandeenRoche Karen,
Burgard Sheila,
Thomas Sonia Davis,
Gottesman Rebecca F.,
Knopman David,
Mosley Thomas,
Klein Barbara,
Klein Ronald
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.10.002
Subject(s) - dementia , medicine , hazard ratio , quartile , retinal , diabetic retinopathy , fundus photography , population , fundus (uterus) , confidence interval , ophthalmology , diabetes mellitus , disease , endocrinology , fluorescein angiography , environmental health
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.