Department of Epidemiology, Erasmus Medical Center, CA Rotterdam, The Netherlands.
Stroke. 2011 Aug;42(8):2138-42. doi: 10.1161/STROKEAHA.111.616359. Epub 2011 Jun 16.
Age-related macular degeneration (AMD) and stroke are both frequent diseases in the elderly. A link between AMD and stroke has been suggested, because both disorders have many risk factors in common. The aim of this study was to investigate the association between AMD and stroke and the subtypes cerebral infarction and intracerebral hemorrhage in the general elderly population.
This study was part of the population-based Rotterdam Study and included 6207 participants aged ≥ 55 years who were stroke-free at baseline (1990 to 1993). Signs of AMD were assessed on fundus photographs at baseline and at regular follow-up examinations and were categorized in 5 stages (0 to 4) representing an increasing severity. Late AMD (Stage 4) was subdivided into dry and wet AMD. Follow-up for incident stroke was complete up to January 1, 2007. Data were analyzed using time-dependent Cox regression models adjusted for age, sex, and potential confounders.
During a median follow-up of 13.6 years, 726 participants developed a stroke (397 cerebral infarction, 59 intracerebral hemorrhage, 270 unspecified). Late AMD was associated with an increased risk of any stroke (hazard ratio, 1.56; 95% CI, 1.08 to 2.26) due to a strong association with intracerebral hemorrhage (hazard ratio, 6.11; 95% CI, 2.34 to 15.98). In contrast, late AMD was not associated with cerebral infarction. Earlier AMD stages were not associated with risk of stroke or any of its subtypes.
We found that late AMD is strongly associated with intracerebral hemorrhage, but not with cerebral infarction, in the general elderly population.
年龄相关性黄斑变性（AMD）和中风都是老年人常见的疾病。AMD 和中风之间存在关联，因为这两种疾病有许多共同的危险因素。本研究旨在调查一般老年人群中 AMD 与中风以及脑梗死和脑出血亚型之间的关系。
本研究是基于人群的鹿特丹研究的一部分，包括 6207 名年龄≥55 岁且基线时无中风的参与者（1990 年至 1993 年）。在基线和定期随访检查时通过眼底照片评估 AMD 迹象，并分为 5 个阶段（0 至 4），代表严重程度逐渐增加。晚期 AMD（第 4 期）进一步分为干性和湿性 AMD。对中风的发病进行了完整的随访，截止日期为 2007 年 1 月 1 日。使用时间依赖性 Cox 回归模型分析数据，模型调整了年龄、性别和潜在混杂因素。
在中位数为 13.6 年的随访期间，726 名参与者发生了中风（397 例脑梗死，59 例脑出血，270 例未明确）。晚期 AMD 与任何中风的风险增加相关（风险比，1.56；95%置信区间，1.08 至 2.26），这主要与脑出血有关（风险比，6.11；95%置信区间，2.34 至 15.98）。相比之下，晚期 AMD 与脑梗死无关。早期 AMD 阶段与中风或其任何亚型的风险无关。
我们发现晚期 AMD 与一般老年人群中的脑出血强烈相关，但与脑梗死无关。
