Association Between Dementia and Optical Coherence Tomography Scan Quality

It is generally assumed that dementia affects the quality of optical coherence tomography (OCT) scans. However, the magnitude of this effect and its independence from other factors require further clarification. In this cross-sectional study, our aim was to evaluate the association between cognitive impairment and OCT scan quality, adjusting for key confounders, in a multiethnic cohort. 541 participants aged 50 years or older were recruited from memory clinics and the community at the National University Hospital and St. Luke's Hospital, Singapore. They were then stratified into three groups: no cognitive impairment (NCI, n=112), cognitive impairment without dementia (CIND, n=235), and dementia (n=194); OCT scan quality was subsequently assessed based on the presence and severity of artifacts. We found that dementia patients were nearly three times more likely to produce poor-quality OCT scans compared to NCI participants (adjusted odds ratio [OR]=2.90; 95% CI, 1.24-6.80). Lower cognitive scores, including Mini-Mental State Examination (MMSE) (OR=0.92; 95% CI, 0.88-0.96), Montreal Cognitive Assessment (MoCA) (OR=0.90; 95% CI, 0.86-0.94), and higher Clinical Dementia Rating (CDR) scores (OR=2.11; 95% CI, 1.43-3.10), were also independently associated with poor scan quality. In conclusion, cognitive impairment, particularly dementia, substantially increases the likelihood of poor-quality OCT scans, even after accounting for key demographic and clinical factors. Hence, strategies tailored to improve imaging in this population are essential for enhancing diagnostic accuracy and patient care.