期刊
JOURNAL OF ALZHEIMERS DISEASE
卷 81, 期 1, 页码 245-253出版社
IOS PRESS
DOI: 10.3233/JAD-201492
关键词
Alzheimer's disease; cohort study; epidemiology; retinal artery occlusion; retinal vascular occlusion; retinal vein occlusion; vascular dementia
资金
- NIH/NEI [K23EY 029246]
- NIH/NIA [R01AG060942, U01AG006781]
- NIH/NIP50 [AG0 5136]
- Research to Prevent Blindness
- Latham Vision Innovation Award
The study found that older patients who present with RAVO and carry the APOE epsilon 4 allele appear to be at higher risk for vascular dementia. There were no significant associations between RAVO and AD in either APOE group.
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 APOE epsilon 4 genotype and adjusted for demographic and clinical factors. Results: On reviewof 41,216 person-years (4,743 participants), 266 (5.6%) experiencedRAVO. APOE epsilon 4 carriers who developedRAVOhad 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 riskwas three-fold higher (HR 3.06, 95% CI 1.23, 7.62). No other conditions evaluated in the secondary analyses were found to confound this relationship. There was no effect in non-APOE epsilon 4 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 APOE epsilon 4 allele appear to be at higher risk for vascular dementia.
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