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

PubMed ID: 30439332

Author(s): Deal JA, Sharrett AR, Albert M, Bandeen-Roche K, Burgard S, Thomas SD, Gottesman RF, Knopman D, Mosley T, Klein B, Klein R. Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities Study. Alzheimers Dement. 2019 Mar;15(3):477-486. doi: 10.1016/j.jalz.2018.10.002. Epub 2018 Nov 12. PMID 30439332

Journal: Alzheimer’s & Dementia : The Journal Of The Alzheimer’s Association, Volume 15, Issue 3, Mar 2019

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.