Abstract

BackgroundThe retinal and cerebral microvasculature share similar embryological origins and physiological characteristics. Improved imaging technologies provide opportunistic non-invasive assessment of retinal microvascular parameters (RMPs) against cognitive outcomes. We evaluated baseline measures for associations between RMPs and mild cognitive impairment (MCI) from participants of the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA).MethodsRMPs (central retinal arteriolar / venular equivalents, arteriole to venular ratio, fractal dimension and tortuosity) were measured from optic disc centred fundus images and analysed using semi-automated software. Associations between RMPs and MCI were assessed by multivariable logistic regression with adjustment for potential confounders including age, sex, alcohol consumption, smoking status, educational attainment, physical activity, cardiovascular disease (CVD), hypertension, mean arterial blood pressure, triglycerides, diabetes, body mass index, and high density lipoprotein levels. P < 0.05 was considered statistically significant.ResultsData were available for 1431 participants, of which 156 (10.9%) were classified with MCI defined by a Montreal Cognitive Assessment (MoCA) score ≤ 26, with subjective cognitive decline, in the absence of depression or problems with activities of daily living. Participants had a mean age of 62.4 ± 8.5 yrs. and 52% were female. As expected, individuals with MCI had a lower MoCA score than those without (23.5 ± 2.6 versus 26.3 ± 2.7, respectively), were more likely to be female, have a lower level of educational attainment, be less physically active, more likely to have CVD, have higher levels of triglycerides and lower levels of high density lipoprotein. No significant associations between RMPs and MCI were detected in unadjusted, minimally adjusted or fully adjusted regression models or subsequent sensitivity analyses.ConclusionPrevious studies have reported both increased retinal venular calibre and reduced fractal dimension in association with mild cognitive impairment. Our study failed to detect any associations between RMPs and those individuals at an early stage of cognitive loss in an older community-based cohort.

Highlights

  • The retinal and cerebral microvasculature share similar embryological origins and physiological characteristics

  • Participants were investigated for subjective cognitive decline (SCD) and a series of questions based on difficulties associated with basic activities of daily living (ADL), such as dressing, walking, bathing or showering, eating, getting in or out of bed, and using the toilet

  • Data were available for 1431 participants who met the study inclusion criteria (Fig. 2)

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Summary

Introduction

The retinal and cerebral microvasculature share similar embryological origins and physiological characteristics. We evaluated baseline measures for associations between RMPs and mild cognitive impairment (MCI) from participants of the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). The most rapidly growing demographic in Northern Ireland (NI) is those aged > 50 years (yrs), necessitating improved understanding of the impact of age-related conditions [3]. Cognitive impairment significantly impacts activities of daily living (ADL), especially among the aged [4, 5]. Some individuals may exceed a threshold characterised as mild cognitive impairment (MCI), which may progress to dementia in up to 50% of cases over 5 years [6,7,8,9,10,11]. Given life expectancy has increased globally, an improved understanding of normal ageing processes will advance measures of successful and healthy ageing and differentiation of normal and diseased states [13, 14]

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