Relationship between Retinal Vascular Occlusions and Cognitive Dementia in a Large Cross-Sectional Cohort

https://doi.org/10.1016/j.ajo.2021.01.026Get rights and content

Purpose

To examine the association between cognitive dementia and retinal vascular occlusions.

Design

A retrospective, cross-sectional study.

Methods

Single-institution study population: we reviewed the electronic medical records of 37,208 individuals older than 65 years of age who were evaluated by an ophthalmologist or an optometrist and who also had a medical visit to our institution over a 6-year period. Individuals with and without retinal vascular occlusions were identified by International Classification of Diseases, version 10 (ICD-10) diagnostic codes.

Main outcome

we analyzed the association between dementia and retinal vascular occlusions after adjusting for covariates which included age, sex, stroke, diabetes mellitus, and hypertension using multiple logistic regression analyses.

Results

Compared to subjects without retinal vascular occlusions, those with retinal vascular occlusions had a higher prevalence of dementia (6.7% vs. 9.3%, respectively; P < .001). After adjusting for either age or stroke, there were no significant associations between retinal vascular occlusions and dementia.

Conclusions

Individuals with retinal vascular occlusions have a higher prevalence of dementia. However, this association is secondary to shared underlying risk factors in this population, such as older age and stroke.

Section snippets

Methods

This was a retrospective, cross-sectional study conducted in accordance with the Health Insurance Portability and Accountability Act. Internal Review Board (IRB) approval was obtained from the University of California San Diego Health System.

We reviewed the records of 37,208 individuals older than 65 years of age, who were evaluated by an ophthalmologist or an optometrist and who also had a medical visit to our institution between January 1, 2015, and December 31, 2020. Individuals with retinal

Results

We identified 904 individuals with and 36,304 individuals without retinal vascular occlusions. Demographics and baseline characteristics of the study cohort are shown in Table 1. Individuals with retinal vascular occlusions were older than those without (79 vs. 76 years of age, respectively; P < .001), and the proportion of females was lower in the retinal vascular occlusion group (51.0 vs. 57.2%, respectively; P < .001). There were no significant differences in race between the groups (P

Discussion

We examined the association between the retinal vascular occlusions and dementia in a retrospective cohort of individuals older than 65 years of age. We found that individuals with retinal vascular occlusions have increased odds of having dementia, in line with a recently published report.3 However, after we adjusted for age or stroke, there were no significant associations between retinal vascular occlusions and dementia.

The major strengths of our study are the large sample size and adjustment

References (31)

  • J Surawan et al.

    Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

    Neurol Int

    (2017)
  • BN Justin et al.

    Heart disease as a risk factor for dementia

    Clin Epidemiol

    (2013)
  • RA Whitmer et al.

    Midlife cardiovascular risk factors and risk of dementia in late life

    Neurology

    (2005)
  • FJ de Jong et al.

    Retinal vascular caliber and risk of dementia: the Rotterdam study

    Neurology

    (2011)
  • YS Zhang et al.

    Parafoveal vessel loss and correlation between peripapillary vessel density and cognitive performance in amnestic mild cognitive impairment and early Alzheimer's disease on optical coherence tomography angiography

    PLoS One

    (2019)
  • Cited by (6)

    • Prevalence of subclinical retinal ischemia in patients with cardiovascular disease – a hypothesis driven study

      2021, EClinicalMedicine
      Citation Excerpt :

      Identifying biomarkers of subclinical ischemia can help identify patients with occult cardiovascular disease. Individuals with cardiovascular disease are prone to developing retinal vascular occlusions [7–20]. The retina is a multi-layered neural tissue with a complex capillary network [21].

    • Beyond Vision: A View from Eye to Alzheimer’s Disease and Dementia

      2024, Journal of Prevention of Alzheimer's Disease
    View full text