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Retinal microvascular signs and functional loss in older persons: the cardiovascular health study.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Retinal microvascular signs and functional loss in older persons: the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Kim, DHyun, Newman, AB, Hajjar, I, Strotmeyer, ES, Klein, R, Newton, E, Sarnak, MJ, Burke, GL, Lipsitz, LA |
| Journal | Stroke |
| Volume | 42 |
| Issue | 6 |
| Pagination | 1589-95 |
| Date Published | 2011 Jun |
| ISSN | 1524-4628 |
| Keywords | Aged, Cardiovascular Diseases, Depressive Disorder, Frontal Lobe, Humans, Microcirculation, Neuropsychological Tests, Retinal Diseases, Retinal Vessels, Risk Factors |
| Abstract | <p><b>BACKGROUND AND PURPOSE: </b>We hypothesized that retinal microvascular signs are associated with executive dysfunction, slow gait, and depressive mood, which are characteristic features of microvascular disease affecting frontal subcortical regions of the brain.</p><p><b>METHODS: </b>In the Cardiovascular Health Study, 1744 participants (mean age, 78) free of stroke had retinal photographs and carotid ultrasound during the 1997 to 1998 visit. We examined the cross-sectional association of retinal signs with the digit-symbol substitution test (DSST) score, gait speed, the Center for Epidemiologic Studies-Depression score, and depressive mood, defined as Center for Epidemiologic Studies-Depression score >9 or antidepressant use.</p><p><b>RESULTS: </b>After adjusting for potential confounders, retinal signs were associated with lower DSST score (generalized arteriolar narrowing and arteriovenous nicking), slower gait (retinopathy), and depressive mood (generalized arteriolar narrowing). A higher number of retinal signs was associated with lower DSST score (-0.76 and -2.79 points for 1 sign and ≥2 signs versus none; P<0.001) and slower gait (-0.009 and -0.083 m/s; P=0.047), but not with the square root of Center for Epidemiologic Studies-Depression score (0.079 and -0.208; P=0.072). In addition, coexistence of retinal signs (generalized arteriolar narrowing and arteriovenous nicking) and carotid atherosclerosis was associated with lower DSST score compared with either process alone (P for interaction <0.01). Notably, further adjustment for ventricular size, white matter disease, and infarcts on MRI did not attenuate the association.</p><p><b>CONCLUSIONS: </b>Retinal signs are associated with executive dysfunction and slow gait, and possibly with depressive mood, suggesting a common process involving small vessels.</p> |
| DOI | 10.1161/STROKEAHA.110.605261 |
| Alternate Journal | Stroke |
| PubMed ID | 21493913 |
| PubMed Central ID | PMC3127407 |
| Grant List | K23-AG-30057 / AG / NIA NIH HHS / United States N01 HC085086 / HC / NHLBI NIH HHS / United States R01-AG-027002 / AG / NIA NIH HHS / United States P30 AG024827 / AG / NIA NIH HHS / United States UL1 TR000005 / TR / NCATS NIH HHS / United States R01 AG027002-01 / AG / NIA NIH HHS / United States K23 AG030057-01A1 / AG / NIA NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States U01 HL080295-04 / HL / NHLBI NIH HHS / United States R37-AG-25037 / AG / NIA NIH HHS / United States P01 AG031720-01A2 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States U01-HL080295 / HL / NHLBI NIH HHS / United States HC-97-06 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States P30 AG028717-01A2 / AG / NIA NIH HHS / United States P01 AG004390 / AG / NIA NIH HHS / United States P30 AG028717-02 / AG / NIA NIH HHS / United States P30-AG-024827 / AG / NIA NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States R21-HL-077166 / HL / NHLBI NIH HHS / United States P30-AG-028717 / AG / NIA NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States P01 AG004390-25 / AG / NIA NIH HHS / United States R37 AG025037-06 / AG / NIA NIH HHS / United States P30 AG024827-08 / AG / NIA NIH HHS / United States P01 AG031720 / AG / NIA NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01-HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States K23 AG030057 / AG / NIA NIH HHS / United States R01 AG027002 / AG / NIA NIH HHS / United States R37 AG025037 / AG / NIA NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States R01 AG023629-01 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States R21 HL077166 / HL / NHLBI NIH HHS / United States R01-AG-023629 / AG / NIA NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States P01-AG-03172 / AG / NIA NIH HHS / United States P30 AG028717 / AG / NIA NIH HHS / United States P01-AG-004390 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States P01-AG-031720 / AG / NIA NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R21 HL077166-02 / HL / NHLBI NIH HHS / United States |