Retinopathy and risk of dementia: the Rotterdam Study.
OBJECTIVE
To investigate the relation between retinopathy and the risk of dementia.


METHODS
We investigated the associations between retinopathy and dementia and its subtypes Alzheimer disease (AD) and vascular dementia both cross-sectionally and prospectively in the Rotterdam Study, a large population-based cohort study. Digitized retinal images were available for 195 participants with prevalent dementia and 6,078 participants without dementia at baseline (1990-1993). Participants were reexamined in 1993-1994, 1997-1999, and 2002-2004 and were continuously monitored for development of dementia until January 1, 2007. Retinopathy was graded on fundus photographs and was defined as the presence of one or more dot/blot hemorrhages, microaneurysms, cotton wool spots, or evidence of laser treatment for retinopathy.


RESULTS
Retinopathy was associated with prevalent dementia (age and sex-adjusted odds ratio 2.04, 95% confidence interval [CI] 1.34-3.09). Results were similar for AD and vascular dementia. During a mean follow-up of 11.4 years, 735 participants developed incident dementia, of whom 583 had AD and 80 had vascular dementia. There was no association of retinopathy at baseline with the risk of incident dementia during follow-up (age- and sex-adjusted hazard ratio 1.15, 95% CI 0.88-1.48) or the risk of incident AD or vascular dementia.


CONCLUSIONS
Retinopathy is more prevalent in persons with dementia but is not associated with an increased risk of dementia over time.
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Elisabeth M C
EM
Schrijvers
Gabriëlle H S
GH
Buitendijk
M Kamran
MK
Ikram
Peter J
PJ
Koudstaal
Albert
A
Hofman
Johannes R
JR
Vingerling
Monique M B
MM
Breteler
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012164:Retinal Diseases / Q000453:epidemiology*; D012306:Risk; D012307:Risk Factors