Authors: Lee, Cecilia S. | Lee, Michael L. | Gibbons, Laura E. | Yanagihara, Ryan T. | Blazes, Marian | Kam, Jason P. | McCurry, Susan M. | Bowen, James D. | McCormick, Wayne C. | Lee, Aaron Y. | Larson, Eric B. | Crane, Paul K.
Article Type: Research Article
Abstract: Background: Vascular disease is a risk factor for Alzheimer’s disease (AD) and related dementia in older adults. Retinal artery/vein occlusion (RAVO) is an ophthalmic complication of systemic vascular pathology. Whether there are associations between RAVO and dementia risk is unknown. Objective: To determine whether RAVOs are associated with an increased risk of developing vascular dementia or AD. Methods: Data from Adult Changes in Thought (ACT) study participants were analyzed. This prospective, population-based cohort study followed older adults (age ≥65 years) who were dementia-free at enrollment for development of vascular dementia or AD based on research criteria. RAVO diagnoses were extracted …from electronic medical records. Cox-regression survival analyses were stratified by APOE ɛ 4 genotype and adjusted for demographic and clinical factors. Results: On review of 41,216 person-years (4,743 participants), 266 (5.6%) experienced RAVO. APOE ɛ 4 carriers who developed RAVO had greater than four-fold higher risk for developing vascular dementia (Hazard Ratio [HR] 4.54, 95% Confidence Interval [CI] 1.86, 11.10, p = 0.001). When including other cerebrovascular disease (history of carotid endarterectomy or transient ischemic attack) in the model, the risk was three-fold higher (HR 3.06, 95% CI 1.23, 7.62). No other conditions evaluated in the secondary analyses were found to confound this relationship. There was no effect in non-APOE ɛ 4 carriers (HR 1.03, 95% CI 0.37, 2.80). There were no significant associations between RAVO and AD in either APOE group. Conclusion: Older dementia-free patients who present with RAVO and carry the APOE ɛ 4 allele appear to be at higher risk for vascular dementia. Show more
Keywords: Alzheimer’s disease, cohort study, epidemiology, retinal artery occlusion, retinal vascular occlusion, retinal vein occlusion, vascular dementia
DOI: 10.3233/JAD-201492
Citation: Journal of Alzheimer's Disease, vol. 81, no. 1, pp. 245-253, 2021
Authors: Lee, Cecilia S. | Ferguson, Alina N. | Gibbons, Laura E. | Walker, Rod | Su, Yu-Ru | Krakauer, Chloe | Brush, Michael | Kam, Jason | Larson, Eric B. | Arterburn, David E. | Crane, Paul K. | Takahashi, Missy | Zhang, Yi | Jiang, Yu | Wu, Yue | Cooper, Julie | Pope, Beth | Blazes, Marian | Lee, Aaron Y. | Lee, Michael L. | Wang, Ruikang | Cronkite, David | Hess, Chantelle | Bowers, Will | Schaaf, Beverly | Gray, Regan | Guerrero, Linda | Sankaran, Sundary | Gatto, Nicole
Article Type: Research Article
Abstract: Background: Conflicting research on retinal biomarkers of Alzheimer’s disease and related dementias (AD/ADRD) is likely related to limited sample sizes, study design, and protocol differences. Objective: The prospective Eye Adult Changes in Thought (Eye ACT) seeks to address these gaps. Methods: Eye ACT participants are recruited from ACT, an ongoing cohort of dementia-free, older adults followed biennially until AD/ADRD, and undergo visual function and retinal imaging assessment either in clinic or at home. Results: 330 participants were recruited as of 03/2023. Compared to ACT participants not in Eye ACT (N = 1868), Eye ACT participants (N = 330) are younger (mean age: 70.3 …versus 71.2, p = 0.014), newer to ACT (median ACT visits since baseline: 3 versus 4, p < 0.001), have more years of education (17.7 versus 16.2, p < 0.001) and had lower rates of visual impairment (12% versus 22%, p < 0.001). Compared to those seen in clinic (N = 300), Eye ACT participants seen at home (N = 30) are older (77.2 versus 74.9, p = 0.015), more frequently female (60% versus 49%, p = 0.026), and have significantly worse visual acuity (71.1 versus 78.9 Early Treatment Diabetic Retinopathy Study letters, p < 0.001) and contrast sensitivity (–1.9 versus –2.1 mean log units at 3 cycles per degree, p = 0.002). Cognitive scores and retinal imaging measurements are similar between the two groups. Conclusions: Participants assessed at home had significantly worse visual function than those seen in clinic. By including these participants, Eye ACT provides a unique longitudinal cohort for evaluating potential retinal biomarkers of dementia. Show more
Keywords: Adult Changes in Thought (ACT), age-related macular degeneration, Alzheimer’s disease, Cognitive Abilities Screening Instrument (CASI) score, contrast sensitivity, Eye Adult Changes in Thought (Eye ACT), ophthalmology, optical coherence measurement, prospective study, visual acuity
DOI: 10.3233/JAD-240203
Citation: Journal of Alzheimer's Disease, vol. 100, no. 1, pp. 309-320, 2024