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TE Clemons, AS Lindblad, WL McBee, LD HubbardAREDS Research Group; Cognitive function in the Age-Related Eye Disease Study (AREDS) . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1906.
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Purpose: To investigate the correlation of age-related macular degeneration (AMD) and use of high-dose vitamin/mineral supplements with cognitive function and depression. Methods: AREDS participants were randomly assigned to receive daily tablets containing (1) antioxidants (vitamin C, vitamin E, and beta carotene); (2) zinc (zinc oxide) and copper (cupric oxide); (3) antioxidants plus zinc; or (4) placebo. The AREDS Cognitive Function Battery includes 6 validated neuropsychological tests measuring performance in several cognitive domains and a depression scale. Participants were classified into one of four AMD categories at the time of administration: (1) no drusen; (2) extensive small drusen or non-extensive intermediate drusen; (3) large drusen, extensive intermediate drusen, or non-central geographic atrophy; and (4) advanced AMD or vision loss due to AMD in at least one eye. Dunnett's multiple comparison test identified differences in means by AMD category and treatment. Cognitive impairment and depression, defined as falling below the 10th percentile of the AREDS population, was assessed using logistic regression. Results: The Battery was administered to 2,681 participants age 61-87 years. Mean scores for a majority of tests declined with age, and differed by race, gender and education level (P<0.05). After adjusting for these factors, participants with advanced AMD were relatively more depressed compared to those without AMD (Odds Ratio (OR)=1.92, 95% CI: 1.27-2.91). After additional adjustment for depression score, participants with advanced AMD compared to those without had a relatively lower Modified Mini Mental State Exam score (OR= 2.61, 95% CI: 1.66-4.10). ORs for the remaining tests were in the direction of risk but none were significant (OR range 1.05-1.40). A risk factor adjusted analysis including baseline AMD category and treatment duration found that zinc significantly reduced cognitive impairment compared to placebo for the Animal Categories Test (OR=0.60, 95%CI: 0.36-0.99). ORs for zinc and the other batteries were not significant (OR range 0.68-1.08). None of the ORs for the antioxidant alone (OR range 0.68-1.23) and antioxidant plus zinc (OR range 0.68-1.25) formulations was significant (OR range 0.68-1.28). Conclusion: These data suggest an association between lower scores on depression and cognitive function test and advanced AMD, but do not support an association between supplementation with antioxidants and/or zinc and cognitive function.
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