03109nas a2200409 4500008004100000022001400041245011700055210006900172260001300241300001100254490000700265520193500272653000902207653002202216653002802238653001402266653002802280653001302308653001102321653001102332653002502343653000902368653002102377653002902398653002002427653001702447100002302464700002802487700002102515700001802536700002402554700002402578700002102602700002102623700002002644856003502664 2007 eng d a1524-462800aRetinal microvascular signs, cognitive function, and dementia in older persons: the Cardiovascular Health Study.0 aRetinal microvascular signs cognitive function and dementia in o c2007 Jul a2041-70 v383 a
BACKGROUND AND PURPOSE: Cerebral microvascular disease may be a risk factor for the development of dementia in elderly persons. We describe the association of retinal microvascular signs with cognitive function and dementia among older individuals.
METHODS: In the population-based Cardiovascular Health Study, 2211 persons aged 69 to 97 years at recruitment had retinal photography. Photographs were evaluated for retinopathy (eg, microaneurysms, retinal hemorrhages), focal arteriolar narrowing, arteriovenous nicking, and retinal arteriolar and venular caliber. Cognitive status was determined from the Digit-Symbol Substitution Test and Modified Mini-Mental State Examination. Participants were also further evaluated for the presence of dementia with detailed neuropsychological testing. Persons with a prior stroke or taking antipsychotic or antidepressant medications were excluded.
RESULTS: After adjusting for age, gender, race, field center, education level, internal carotid intima-media thickness, body mass index, hypertension, diabetes, and cigarette smoking status, persons with retinopathy had lower mean Digit-Symbol Substitution Test scores but not Modified Mini-Mental State Examination than those without retinopathy (39 versus 41, P=0.002). In hypertensive persons, retinopathy (multivariable-adjusted OR, 2.10; 95% CI, 1.04 to 4.24) and focal arteriolar narrowing (OR, 3.02; 95% CI, 1.51 to 6.02) were associated with dementia. These associations were not present in individuals without hypertension.
CONCLUSIONS: In older persons, our study shows a modest cross-sectional association between retinopathy signs with poorer cognitive function and, in persons with hypertension, with dementia. These data support a possible role of cerebral microvascular disease in the pathogenesis of impaired cognitive function and dementia in older hypertensive persons.
10aAged10aAged, 80 and over10aCardiovascular Diseases10aCognition10aCross-Sectional Studies10aDementia10aFemale10aHumans10aLongitudinal Studies10aMale10aMicrocirculation10aNeuropsychological Tests10aRetinal Vessels10aRisk Factors1 aBaker, Michelle, L1 aLarsen, Emily, K Marino1 aKuller, Lewis, H1 aKlein, Ronald1 aKlein, Barbara, E K1 aSiscovick, David, S1 aBernick, Charles1 aManolio, Teri, A1 aWong, Tien, Yin uhttps://chs-nhlbi.org/node/965