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Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study

TitleRetinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study
Publication TypeJournal Article
Year of Publication2018
AuthorsDeal, JA, Sharrett, AR, Albert, M, Bandeen-Roche, K, Burgard, S, Thomas, SD, Gottesman, RF, Knopman, D, Mosley, T, Klein, B, Klein, R
JournalAlzheimers Dement
Date PublishedNov 12
ISBN Number1552-5260
Accession Number30439332
KeywordsCohort Studies, Dementia, diabetes, Microvasculature, Retinal, Risk factors in epidemiology
Abstract

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.