Associations Between Retinal Artery/Vein Occlusions and Risk of 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, 7.62). 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.

• Authors: Cecilia S Lee, Michael L Lee, Laura E Gibbons, Ryan T Yanagihara, Marian Blazes, Jason P Kam, Susan M McCurry, James D Bowen, Wayne C McCormick, Aaron Y Lee, Eric B Larson, Paul K Crane
• Journal: Journal of Alzheimer's disease : JAD (J Alzheimers Dis) Vol. 81 Issue 1 Pg. 245-253 ( 2021) ISSN: 1875-8908 [Electronic] Netherlands
• PMID: 33749651 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Dementia, Vascular (etiology)
• Female
• Humans
• Male
• Prospective Studies
• Retinal Artery Occlusion (complications)
• Retinal Vein Occlusion (complications)
• Risk Factors