title: Retinal microvascular signs and cognitive impairment.
abstract: OBJECTIVE
  To examine the association between retinal microvascular signs, as a proxy for cerebral microvascular disease, and cognitive impairment.
  
  
  METHODS
  Cross-sectional population-based study.
  
  
  METHODS
  Urban population survey
  
  
  METHODS
  One thousand nine hundred eighty-eight persons aged 49 to 97.
  
  
  METHODS
  All participants underwent retinal photography and had the Mini-Mental State Examination (MMSE) administered by trained personnel. Retinal photographs were masked and graded for retinopathy signs (microaneurysms, hemorrhages, hard exudates, cotton wool spots), and retinal vessel calibers were measured using a validated computer-assisted method. Cognitive impairment was defined as an MMSE score of 23 or less, in line with other epidemiological studies.
  
  
  RESULTS
  Cognitive impairment was present in 121 participants (6.1%). In the total population, after adjusting for age, sex, blood pressure, diabetes mellitus, smoking, cardiovascular disease, education, and other factors, retinal venular dilation was associated with cognitive impairment (odds ratio (OR)=1.8, 95% confidence interval (95% CI)=1.0-3.2, P=.03). In persons with hypertension, retinopathy signs (adjusted OR=1.7, 95% CI=1.0-3.2, P=.05) and retinal venular dilation (adjusted OR=2.7, 95% CI=1.2-6.1, P=.01) were associated with cognitive impairment.
  
  
  CONCLUSIONS
  Retinal microvascular signs are associated with significant cognitive impairment, particularly in older persons with hypertension. These findings suggest that cerebral microvascular changes may contribute to cognitive deterioration.
authors.affiliation: Centre for Vision Research, University of Sydney, Sydney, Australia.
authors.forename: Gerald
authors.initials: G
authors.lastname: Liew
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.forename: Richard I
authors.initials: RI
authors.lastname: Lindley
authors.forename: Ning
authors.initials: N
authors.lastname: Cheung
authors.forename: Shweta
authors.initials: S
authors.lastname: Kaushik
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis; D003072:Cognition Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D055806:Microvessels; D012171:Retinal Vessels; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis