Document Detail


Retinal microvascular signs and functional loss in older persons: the cardiovascular health study.
MedLine Citation:
PMID:  21493913     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: We hypothesized that retinal microvascular signs are associated with executive dysfunction, slow gait, and depressive mood, which are characteristic features of microvascular disease affecting frontal subcortical regions of the brain.
METHODS: In the Cardiovascular Health Study, 1744 participants (mean age, 78) free of stroke had retinal photographs and carotid ultrasound during the 1997 to 1998 visit. We examined the cross-sectional association of retinal signs with the digit-symbol substitution test (DSST) score, gait speed, the Center for Epidemiologic Studies-Depression score, and depressive mood, defined as Center for Epidemiologic Studies-Depression score >9 or antidepressant use.
RESULTS: After adjusting for potential confounders, retinal signs were associated with lower DSST score (generalized arteriolar narrowing and arteriovenous nicking), slower gait (retinopathy), and depressive mood (generalized arteriolar narrowing). A higher number of retinal signs was associated with lower DSST score (-0.76 and -2.79 points for 1 sign and ≥2 signs versus none; P<0.001) and slower gait (-0.009 and -0.083 m/s; P=0.047), but not with the square root of Center for Epidemiologic Studies-Depression score (0.079 and -0.208; P=0.072). In addition, coexistence of retinal signs (generalized arteriolar narrowing and arteriovenous nicking) and carotid atherosclerosis was associated with lower DSST score compared with either process alone (P for interaction <0.01). Notably, further adjustment for ventricular size, white matter disease, and infarcts on MRI did not attenuate the association.
CONCLUSIONS: Retinal signs are associated with executive dysfunction and slow gait, and possibly with depressive mood, suggesting a common process involving small vessels.
Authors:
Dae Hyun Kim; Anne B Newman; Ihab Hajjar; Elsa S Strotmeyer; Ronald Klein; Elizabeth Newton; Mark J Sarnak; Gregory L Burke; Lewis A Lipsitz
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-04-14
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-30     Completed Date:  2011-08-05     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1589-95     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiovascular Diseases / pathology,  physiopathology*
Depressive Disorder / physiopathology
Frontal Lobe / pathology,  physiopathology
Humans
Microcirculation
Neuropsychological Tests
Retinal Diseases / physiopathology*
Retinal Vessels / physiopathology*
Risk Factors
Grant Support
ID/Acronym/Agency:
HC-97-06/HC/NHLBI NIH HHS; K23 AG030057/AG/NIA NIH HHS; K23 AG030057-01A1/AG/NIA NIH HHS; K23-AG-30057/AG/NIA NIH HHS; N01 HC015103/HC/NHLBI NIH HHS; N01 HC035129/HC/NHLBI NIH HHS; N01 HC045133/HC/NHLBI NIH HHS; N01 HC055222/HC/NHLBI NIH HHS; N01 HC075150/HC/NHLBI NIH HHS; N01 HC085079/HC/NHLBI NIH HHS; N01 HC085080/HC/NHLBI NIH HHS; N01 HC085081/HC/NHLBI NIH HHS; N01 HC085082/HC/NHLBI NIH HHS; N01 HC085083/HC/NHLBI NIH HHS; N01 HC085084/HC/NHLBI NIH HHS; N01 HC085085/HC/NHLBI NIH HHS; N01 HC085086/HC/NHLBI NIH HHS; N01-HC-15103/HC/NHLBI NIH HHS; N01-HC-35129/HC/NHLBI NIH HHS; N01-HC-45133/HC/NHLBI NIH HHS; N01-HC-55222/HC/NHLBI NIH HHS; N01-HC-75150/HC/NHLBI NIH HHS; N01-HC-85079/HC/NHLBI NIH HHS; N01-HC-85086/HC/NHLBI NIH HHS; P01 AG004390/AG/NIA NIH HHS; P01 AG004390-25/AG/NIA NIH HHS; P01 AG031720/AG/NIA NIH HHS; P01 AG031720-01A2/AG/NIA NIH HHS; P01-AG-004390/AG/NIA NIH HHS; P01-AG-03172/AG/NIA NIH HHS; P01-AG-031720/AG/NIA NIH HHS; P30 AG024827/AG/NIA NIH HHS; P30 AG024827-08/AG/NIA NIH HHS; P30 AG028717/AG/NIA NIH HHS; P30 AG028717-01A2/AG/NIA NIH HHS; P30 AG028717-02/AG/NIA NIH HHS; P30-AG-024827/AG/NIA NIH HHS; P30-AG-028717/AG/NIA NIH HHS; R01 AG023629/AG/NIA NIH HHS; R01 AG023629-01/AG/NIA NIH HHS; R01 AG027002/AG/NIA NIH HHS; R01 AG027002-01/AG/NIA NIH HHS; R01-AG-023629/AG/NIA NIH HHS; R01-AG-027002/AG/NIA NIH HHS; R21 HL077166-02/HL/NHLBI NIH HHS; R21-HL-077166/HL/NHLBI NIH HHS; R37 AG025037/AG/NIA NIH HHS; R37 AG025037-06/AG/NIA NIH HHS; R37-AG-25037/AG/NIA NIH HHS; U01 HL080295/HL/NHLBI NIH HHS; U01 HL080295-04/HL/NHLBI NIH HHS; U01-HL080295/HL/NHLBI NIH HHS
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