Associations Between Retinal Artery/Vein Occlusions and Risk of Vascular Dementia.
Document Type
Article
Publication Date
3-15-2021
Publication Title
Journal of Alzheimer's disease : JAD
Keywords
washington; seattle; swedish neuro; Alzheimer’s disease; cohort study; epidemiology; retinal artery occlusion; retinal vascular occlusion; retinal vein occlusion; vascular dementia
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 APOEɛ4 genotype and adjusted for demographic and clinical factors.
RESULTS: On review of 41,216 person-years (4,743 participants), 266 (5.6%) experienced RAVO. APOEɛ4 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, 76.2). No other conditions evaluated in the secondary analyses were found to confound this relationship. There was no effect in non-APOEɛ4 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 APOEɛ4 allele appear to be at higher risk for vascular dementia.
Clinical Institute
Neurosciences (Brain & Spine)
Department
Neurosciences
Department
Ophthalmology
Department
Population Health
Recommended Citation
Lee, Cecilia S; Lee, Michael L; Gibbons, Laura E; Yanagihara, Ryan T; Blazes, Marian; Kam, Jason P; McCurry, Susan M; Bowen, J D; McCormick, Wayne C; Lee, Aaron Y; Larson, Eric B; and Crane, Paul K, "Associations Between Retinal Artery/Vein Occlusions and Risk of Vascular Dementia." (2021). Articles, Abstracts, and Reports. 4590.
https://digitalcommons.providence.org/publications/4590
