Issue 108 Item 8 Retinopathy Associated With Cognitive Impairment

Study shows an independent relationship between retinopathy and cognitive impairment. The results of a study published in the June issue of Stroke suggest that there is an independent association between retinopathy and cognitive impairment in middle-aged individuals who have not had a stroke.

Dr. Tien Yin Wong, of the National University of Singapore, and colleagues examined the association between retinal microvascular abnormalities and cognitive impairment in 8734 middle-age subjects every 3 years from 1987 to 1998. At baseline, all of the subjects, who were participants in the Atherosclerosis Risk in Communities study, had not experienced a stroke.

During patient office visits, the researchers obtained retinal photographs and examined them for retinal microvascular abnormalities. Standardized tests, including the Delayed Word Recall Test, Digit Symbol Subtest, and Word Fluency Test were then used to assess cognitive function.

Retinopathy was associated with lower cognitive test scores after adjustment for education, diabetes, blood pressure, carotid intima-media thickness and other risk factors. "The adjusted odds ratios for persons with Delayed Word Recall scores 2 SD or lower than the mean were 2.60 for any retinopathy, 3.00 for microaneurysms, 3.39 for retinal hemorrhage, and 3.07 for soft exudates," the team reports.

Because diabetes and hypertension are known to influence retinopathy and cognitive function, the team repeated the analyses in subjects with and without these conditions. The results of the cognitive tests were similar in both groups.

These results suggest that cerebral microvascular disease may play an important role in the pathogenesis of cognitive impairment, Dr. Wong and colleagues note. "Longitudinal data may clarify the temporal sequence of these associations and the eventual clinical significance of these small, early cognitive function changes." Stroke 2002;https://www.strokeaha.org