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Using Retinal Imaging to Study Dementia
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Prevalence of Retinal Signs and Association With Cognitive Status: The ARIC Neurocognitive Study

Moon Jeong Lee1, Jennifer A Deal2,3, Pradeep Y Ramulu1

  • 1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Journal of the American Geriatrics Society
|February 2, 2019
PubMed

Insights

Retinal hemorrhages and arteriovenous nicking are linked to increased odds of cognitive decline, particularly with cerebrovascular disease. These retinal signs may indicate brain microvascular changes, but further research is needed for clinical use.

Area of Science:

  • Ophthalmology
  • Neurology
  • Gerontology

Background:

  • Retinal microvascular signs are potential indicators of systemic vascular health.
  • Cognitive impairment, including Alzheimer disease and cerebrovascular disease, is a growing public health concern.

Purpose of the Study:

  • To investigate the prevalence of retinal microvascular signs.
  • To examine the association between these retinal signs and cognitive status in an older, biracial cohort.

Main Methods:

  • Cross-sectional analysis of the Atherosclerosis Risk in Communities (ARIC) cohort, visit 5 (2011-2013).
  • Retinal signs were assessed using fundus photography.
  • Cognitive status included normal cognition, mild cognitive impairment (MCI)/dementia with or without cerebrovascular disease (CVD).

Main Results:

  • Prevalence of mild retinopathy was 6%, moderate/severe was 2%. Microaneurysms were present in 7%, retinal hemorrhages in 6%, and AV nicking in 8%.
  • Retinal hemorrhages were associated with a two-fold higher odds of all-cause MCI/dementia and a 2.5-fold higher odds of MCI/dementia with CVD.
  • AV nicking showed a 1.6-fold higher odds of MCI/dementia with CVD.

Conclusions:

  • Retinal microvascular signs may reflect brain microvascular pathology contributing to cognitive decline.
  • The current clinical utility is limited by low prevalence and modest associations.
  • Further research using advanced imaging is needed to enhance sensitivity for dementia risk identification.
Abstract

Keywords:
cognitiondementiamild cognitive impairmentretinopathy

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