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M.L. Baker, T.Y. Wong, E.M. Larsen, R. Klein, B.E. K. Klein, L.H. Kuller, D.S. Siscovick, C. Bernick, T.A. Manolio; Retinal Microvascular Signs Are Associated With Cognitive Impairment in Older People: The Cardiovascular Health Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):921.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the association of retinal microvascular signs with cognitive function in older people free of stroke in the Cardiovascular Health Study (CHS).
This cross–sectional analysis comprised 2,211 persons (aged 69 to 97 years at recruitment) sampled from four U.S. communities during 1989–1998. Participants had standardized retinal photographs which were evaluated for retinopathy, focal arteriolar narrowing, arterio–venous nicking and retinal vascular caliber. Cognitive status was determined from Digit–Symbol Substitution Test (DSST) and Modified Mini–Mental State Examination (3MSE). Persons with prior clinical stroke or who were taking anti–psychotic or anti–depressant medications were excluded.
After adjusting for age, persons with than without retinopathy had lower mean DSST scores (37 vs 41, p<0.001) and lower 3MSE scores (90 vs 92, p=0.001). The association of retinopathy and lower mean DSST scores persisted (38 vs 41, p=0.002) after further adjustment for gender, race, education, hypertension, diabetes, internal carotid intima–media thickness, body mass index and cigarette smoking, but the association of retinopathy and 3MSE score was no longer present (92 vs 93, p=0.211). The relationship of retinopathy to DSST was similar for persons with microaneurysms and retinal haemorrhages. Other retinal microvascular signs were not associated with either DSST and 3MSE.
These data provide modest evidence of an association of retinal microvascular abnormalities and lower cognitive function scores in older people, suggesting a possible role of cerebral microvascular disease in the occurrence of cognitive impairment.
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