Retinal Vascular Changes and Prospective Risk of Disabling Dementia: the Circulatory Risk in Communities Study (CIRCS)

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  • Jinnouchi Hiroshige
    Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
  • Kitamura Akihiko
    Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine Osaka Center for Cancer and Cardiovascular Disease Prevention Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
  • Yamagishi Kazumasa
    Osaka Center for Cancer and Cardiovascular Disease Prevention Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba
  • Kiyama Masahiko
    Osaka Center for Cancer and Cardiovascular Disease Prevention
  • Imano Hironori
    Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
  • Okada Takeo
    Osaka Center for Cancer and Cardiovascular Disease Prevention
  • Cui Renzhe
    Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
  • Umesawa Mitsumasa
    Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba Department of Public Health, Dokkyo Medical University School of Medicine
  • Muraki Isao
    Osaka Center for Cancer and Cardiovascular Disease Prevention
  • Hayama-Terada Mina
    Osaka Center for Cancer and Cardiovascular Disease Prevention
  • Kawasaki Ryo
    Department of Public Health, Yamagata University Graduate School of Medical Science
  • Sankai Tomoko
    Department of Community Health, Faculty of Medicine, University of Tsukuba
  • Ohira Tetsuya
    Department of Epidemiology, Fukushima Medical University School of Medicine
  • Iso Hiroyasu
    Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
  • for the CIRCS Investigators

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<p>Aim: To investigate the association of retinal vascular changes with a risk of dementia in longitudinal population-based study.</p><p>Methods: We performed a nested case-control study of 3,718 persons, aged 40–89 years, enrolled between 1983 and 2004. Retinal vascular changes were observed in 351 cases with disabling dementia (average period before the onset, 11.2 years) and in 702 controls matched for sex, age, and baseline year. Incidence of disabling dementia was defined as individuals who received cares for disabilities including dementia-related symptoms and/or behavioral disturbance. Conditional logistic regression analysis was used to calculate odds ratio (OR) and multivariable adjusted OR (Models 1 and 2) for incidence of disabling dementia according to each retinal vascular change. Regarding confounding variables, Model 1 included overweight status, hypertension, hyperglycemia, dyslipidemia, and smoking status, whereas Model 2 also included incidence of stroke prior to disabling dementia for further analysis.</p><p>Results: The proportion of cases (controls) with retinal vascular changes was 23.1 (15.7)% for generalized arteriolar narrowing, 7.7 (7.5)% for focal arteriolar narrowing, 15.7 (11.8)% for arteriovenous nicking, 10.5 (9.3)% for increased arteriolar wall reflex, and 11.4 (9.8)% for any other retinopathy. Generalized arteriolar narrowing was associated with an increased risk of disabling dementia: crude OR, 1.66 (95% confidence interval, 1.19–2.31); Model 1: OR, 1.58 (1.12–2.23); Model 2: OR, 1.48 (1.04–2.10). The number of retinal abnormalities was associated in a dose–response manner with the risk.</p><p>Conclusion: Generalized arteriolar narrowing and total number of retinal abnormalities may be useful markers for identifying persons at higher risks of disabling dementia.</p>

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