title: Window to the brain: Can retinopathy be used to assess cognitive function.
abstract: OBJECTIVE
  Retinopathy status as a screening method to predict cognitive health is limited. The objective of this study was to examine the association between retinopathy and lowered cognitive performance in a Canadian First Nations population.
  
  
  METHODS
  Eligible individuals were assessed by the Clock Drawing Test (CDT) and the Trail Making Test Parts A and B, which were combined into an executive function score (TMT-exec). Digital fundus photographs were taken for both eyes to assess retinopathy. Anthropometric, vascular and metabolic risk factors were assessed by interview, clinical examinations and blood tests. Carotid atherosclerosis was assessed by Doppler ultrasonography.
  
  
  RESULTS
  Retinopathy was detected in 7.1% of the population. Individuals classified as having a previous history of cardiovascular disease, insulin resistance and diabetes were more likely to have retinopathy. No other cardiovascular risk factors were associated. In unadjusted analysis, there were no associations between retinopathy and lowered cognitive performance (CDT, odds ratio [OR]: 0.86, 95% confidence interval [CI]: 0.30–2.53; TMT-exec, OR: 1.79, 95% CI: 0.60–5.33). Multivariable adjusted analysis also showed no associations, although sample size may be limiting.
  
  
  CONCLUSIONS
  Retinopathy was not associated with lowered cognitive performance. Associations for microvascular risk factors suggest a panel of cognitive tests is needed for future studies.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. jennifer.fergenbaum@utoronto.ca
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Fergenbaum
authors.forename: Sharon
authors.initials: S
authors.lastname: Bruce
authors.forename: Wendy
authors.initials: W
authors.lastname: Lou
authors.forename: Anthony J G
authors.initials: AJ
authors.lastname: Hanley
authors.forename: Carol
authors.initials: C
authors.lastname: Greenwood
authors.forename: T Kue
authors.initials: TK
authors.lastname: Young
mesh_terms: D000328:Adult; D000886:Anthropometry; D002170:Canada; D002318:Cardiovascular Diseases / Q000150:complications* / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012164:Retinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012307:Risk Factors; D013647:Task Performance and Analysis; D014145:Trail Making Test