Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study

Jennifer A. Deal, A. Richey Sharrett, Andreea M. Rawlings, Rebecca F. Gottesman, Karen Bandeen-Roche, Marilyn Albert, David S Knopman, Elizabeth Selvin, Bruce A. Wasserman, Barbara Klein, Ronald Klein

Research output: Contribution to journalArticle

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Abstract

Objective To test the hypothesis that retinal vascular signs are associated with greater cognitive decline over 20 years in 12,317 men and women 50 to 73 years of age at baseline. Methods A composite cognitive score was created with 3 neuropsychological tests measured at 3 time points (1990-1992 to 2011-2013). Retinal signs were measured with fundus photography (1993-1995). Differences in cognitive change by retinal signs status were estimated with linear mixed models. Cognitive scores were imputed for living participants with incomplete cognitive testing. Results In multivariable-adjusted analyses that controlled for attrition, loss of vascular integrity (retinopathy and its components) was associated with greater 20-year decline (difference in 20-year cognitive change for moderate/severe vs no retinopathy-0.53 SD, 95% confidence interval-0.74 to-0.33). Estimated differences were similar in participants with and without diabetes mellitus and in white and black participants. Conclusions Retinopathy was associated with accelerated rates of 20-year cognitive decline. These findings support the exploration of more sensitive measures in the eye such as optical coherence tomography angiography, which may provide surrogate indexes of microvascular lesions relevant to cognitive decline in older adults.

Original languageEnglish (US)
Pages (from-to)e1158-e1166
JournalNeurology
Volume90
Issue number13
DOIs
StatePublished - Mar 27 2018

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Atherosclerosis
Retinal Vessels
Neuropsychological Tests
Photography
Optical Coherence Tomography
Blood Vessels
Linear Models
Diabetes Mellitus
Angiography
Confidence Intervals
Cognitive Dysfunction
hydroquinone

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Deal, J. A., Richey Sharrett, A., Rawlings, A. M., Gottesman, R. F., Bandeen-Roche, K., Albert, M., ... Klein, R. (2018). Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study. Neurology, 90(13), e1158-e1166. https://doi.org/10.1212/WNL.0000000000005205

Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study. / Deal, Jennifer A.; Richey Sharrett, A.; Rawlings, Andreea M.; Gottesman, Rebecca F.; Bandeen-Roche, Karen; Albert, Marilyn; Knopman, David S; Selvin, Elizabeth; Wasserman, Bruce A.; Klein, Barbara; Klein, Ronald.

In: Neurology, Vol. 90, No. 13, 27.03.2018, p. e1158-e1166.

Research output: Contribution to journalArticle

Deal, JA, Richey Sharrett, A, Rawlings, AM, Gottesman, RF, Bandeen-Roche, K, Albert, M, Knopman, DS, Selvin, E, Wasserman, BA, Klein, B & Klein, R 2018, 'Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study', Neurology, vol. 90, no. 13, pp. e1158-e1166. https://doi.org/10.1212/WNL.0000000000005205
Deal JA, Richey Sharrett A, Rawlings AM, Gottesman RF, Bandeen-Roche K, Albert M et al. Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study. Neurology. 2018 Mar 27;90(13):e1158-e1166. https://doi.org/10.1212/WNL.0000000000005205
Deal, Jennifer A. ; Richey Sharrett, A. ; Rawlings, Andreea M. ; Gottesman, Rebecca F. ; Bandeen-Roche, Karen ; Albert, Marilyn ; Knopman, David S ; Selvin, Elizabeth ; Wasserman, Bruce A. ; Klein, Barbara ; Klein, Ronald. / Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study. In: Neurology. 2018 ; Vol. 90, No. 13. pp. e1158-e1166.
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