title: Associations between retinal microvascular changes and dementia, cognitive functioning, and brain imaging abnormalities: a systematic review.
abstract: Retinal microvascular changes can be visualized noninvasively and have been associated with cognitive decline and brain changes in relation to aging and vascular disease. We systematically reviewed studies, published between 1990 and November 2012, on the association between retinal microvascular changes and dementia, cognitive functioning, and brain imaging abnormalities, in the context of aging and vascular risk factors. In cross-sectional studies (k=26), retinal microvascular changes were associated with the presence of dementia (range of odds ratios (ORs) 1.17;5.57), with modest decrements in cognitive functioning in nondemented people (effect sizes -0.25;0.03), and with brain imaging abnormalities, including atrophy and vascular lesions (ORs 0.94;2.95). Longitudinal studies were more sparse (k=9) and showed no consistent associations between retinal microvascular changes and dementia or cognitive dysfunctioning 3 to 15 years later (ORs and hazard ratios 0.77;1.55). However, there were indications of prospective associations with brain imaging abnormalities ((ORs) 0.81;3.19). In conclusion, particularly in cross-sectional studies there is a correlation between retinal microvascular changes and dementia, cognitive impairment, and brain imaging abnormalities. Associations are strongest for more severe retinal microvascular abnormalities. Retinal microvascular abnormalities may offer an important window on the brain for etiological studies.
authors.affiliation: Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands. s.m.heringa@umcutrecht.nl
authors.forename: Sophie M
authors.initials: SM
authors.lastname: Heringa
authors.forename: Willem H
authors.initials: WH
authors.lastname: Bouvy
authors.forename: Esther
authors.initials: E
authors.lastname: van den Berg
authors.forename: Annette C
authors.initials: AC
authors.lastname: Moll
authors.forename: L Jaap
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: Geert Jan
authors.initials: GJ
authors.lastname: Biessels
mesh_terms: D000375:Aging / Q000473:pathology; D000818:Animals; D001921:Brain / Q000473:pathology*; D003071:Cognition / Q000502:physiology*; D003704:Dementia / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D055806:Microvessels / Q000473:pathology*; D012171:Retinal Vessels / Q000473:pathology*