早期年龄相关性黄斑变性、认知功能与痴呆：心血管健康研究
Early age-related macular degeneration, cognitive function, and dementia: the Cardiovascular Health Study.
作者信息
Baker Michelle L, Wang Jie Jin, Rogers Sophie, Klein Ronald, Kuller Lewis H, Larsen Emily K, Wong Tien Yin
机构信息
Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia.
出版信息
Arch Ophthalmol. 2009 May;127(5):667-73. doi: 10.1001/archophthalmol.2009.30.
OBJECTIVE
To describe the association of cognitive function and dementia with early age-related macular degeneration (AMD) in older individuals.
METHODS
This population-based study included 2,088 persons aged 69 to 97 years who participated in the Cardiovascular Health Study. The AMD was assessed from retinal photographs based on a modified Wisconsin AMD grading system. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST) and the Modified Mini-Mental State Examination. Participants were also evaluated for dementia using detailed neuropsychological testing.
RESULTS
After controlling for age, sex, race, and study center, persons with low DSST scores (lowest quartile of scores, < or =30) were more likely to have early AMD (odds ratio, 1.38; 95% confidence interval, 1.03-1.85) than were persons with higher DSST scores. In analyses further controlling for education, systolic blood pressure, total cholesterol level, diabetes mellitus, smoking status, and apolipoprotein E genotype, this association was stronger (odds ratio, 2.00; 95% confidence interval, 1.29-3.10). There was no association of low Modified Mini-Mental State Examination scores, dementia, or Alzheimer disease with early AMD.
CONCLUSIONS
In this older population, cognitive impairment may share common age-related pathogenesis and risk factors with early AMD.
目的
描述老年人中认知功能和痴呆与早期年龄相关性黄斑变性（AMD）之间的关联。
方法
这项基于人群的研究纳入了2088名年龄在69至97岁之间、参与心血管健康研究的人员。根据改良的威斯康星AMD分级系统，通过视网膜照片评估AMD。使用数字符号替换测验（DSST）和改良简易精神状态检查评估认知功能。还通过详细的神经心理学测试对参与者进行痴呆评估。
结果
在控制了年龄、性别、种族和研究中心后，与DSST得分较高的人相比，DSST得分较低（得分最低四分位数，≤30）的人更有可能患有早期AMD（优势比，1.38；95%置信区间，1.03 - 1.85）。在进一步控制教育程度、收缩压、总胆固醇水平、糖尿病、吸烟状况和载脂蛋白E基因型的分析中，这种关联更强（优势比，2.00；95%置信区间，1.29 - 3.10）。改良简易精神状态检查得分低、痴呆或阿尔茨海默病与早期AMD之间无关联。
结论
在这个老年人群中，认知障碍可能与早期AMD具有共同的年龄相关发病机制和危险因素。
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