June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Cognitive Impairment and Progression to Late Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2 (AREDS2) 10-year Follow-on
Author Affiliations & Notes
  • Jimmy T Le
    National Eye Institute, Bethesda, Maryland, United States
  • Elvira Agron
    National Eye Institute, Bethesda, Maryland, United States
  • Tiarnan D L Keenan
    National Eye Institute, Bethesda, Maryland, United States
  • Traci E Clemons
    The Emmes Company LLC, Rockville, Maryland, United States
  • Willa D Brenowitz
    University of California San Francisco, San Francisco, California, United States
  • Kristine Yaffe
    University of California San Francisco, San Francisco, California, United States
  • Emily Y Chew
    National Eye Institute, Bethesda, Maryland, United States
  • Footnotes
    Commercial Relationships   Jimmy Le, None; Elvira Agron, None; Tiarnan Keenan, None; Traci Clemons, None; Willa Brenowitz, None; Kristine Yaffe, None; Emily Chew, None
  • Footnotes
    Support  Intramural Program Funds from the National Eye Institute/National Institutes of Health
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2945. doi:
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      Jimmy T Le, Elvira Agron, Tiarnan D L Keenan, Traci E Clemons, Willa D Brenowitz, Kristine Yaffe, Emily Y Chew; Cognitive Impairment and Progression to Late Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2 (AREDS2) 10-year Follow-on. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2945.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Cognitive impairment and age-related macular degeneration (AMD) are progressive, often irreversible causes of disability. Using 10-year longitudinal data from the Age-Related Eye Disease Study 2 (AREDS2), a multi-center randomized trial of nutritional supplements in older people, we investigated bidirectional associations between cognitive impairment and late AMD.

Methods : AREDS2 participants received annual eye exams and regular testing of cognitive function, which included the Modified Telephone Interview for Cognitive Status (TICS-M). A centralized reading center reviewed fundus photographs to assign severity ratings using the AREDS AMD severity scale (i.e., a score ≥7 indicated worse AMD severity) and determine progression to late AMD (i.e., development of geographic atrophy or choroidal neovascularization). Proportional hazards regression was used to examine associations between cognitive impairment (i.e., a TICS-M score <30) and progression to late AMD by the end of the trial (5-years) and extended follow-up (10-years). Associations between having worse AMD severity at baseline and development of cognitive impairment was also examined. Models were adjusted for baseline age, gender, and risk factors (e.g., smoking status).

Results : The analysis included 5189 eyes (3157 participants from 82 US clinics). Most participants were female (57%) older adults (mean 73 years), who never smoked (43%) or were former (50%) smokers at baseline. Eyes of cognitively impaired participants were more likely to progress to late AMD at 5 years (HR, 1.24; 95%CI, 1.08-1.43) and 10 years (HR, 1.20; 95%CI, 1.05-1.37), compared with eyes of those who were not cognitively impaired (Figure). No associations were observed between worse AMD severity at baseline and development of cognitive impairment at 5 years (HR, 1.13; 95%CI, 0.89-1.44) or 10 years (HR, 1.10; 95%CI, 0.92-1.32).

Conclusions : Our finding that people with cognitive impairment were more likely to progress to late AMD calls for greater awareness of the importance of eye care for people with cognitive impairment. Cognitive impairment may impede on a person’s ability to identify changes in their vision, or that individual may not have adequate access to eyecare services because of more obvious issues linked to impaired cognition.

This is a 2021 ARVO Annual Meeting abstract.

 

Cumulative incidence of eyes progressing to late AMD by cognitive impairment status

Cumulative incidence of eyes progressing to late AMD by cognitive impairment status

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