Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Neurology. 2012 Jul 24;79(4):365-70. doi: 10.1212/WNL.0b013e318260cd7e. Epub 2012 Jul 11.
To investigate the relation between retinopathy and the risk of dementia.
We investigated the associations between retinopathy and dementia and its subtypes Alzheimer disease (AD) and vascular dementia both cross-sectionally and prospectively in the Rotterdam Study, a large population-based cohort study. Digitized retinal images were available for 195 participants with prevalent dementia and 6,078 participants without dementia at baseline (1990-1993). Participants were reexamined in 1993-1994, 1997-1999, and 2002-2004 and were continuously monitored for development of dementia until January 1, 2007. Retinopathy was graded on fundus photographs and was defined as the presence of one or more dot/blot hemorrhages, microaneurysms, cotton wool spots, or evidence of laser treatment for retinopathy.
Retinopathy was associated with prevalent dementia (age and sex-adjusted odds ratio 2.04, 95% confidence interval [CI] 1.34-3.09). Results were similar for AD and vascular dementia. During a mean follow-up of 11.4 years, 735 participants developed incident dementia, of whom 583 had AD and 80 had vascular dementia. There was no association of retinopathy at baseline with the risk of incident dementia during follow-up (age- and sex-adjusted hazard ratio 1.15, 95% CI 0.88-1.48) or the risk of incident AD or vascular dementia.
Retinopathy is more prevalent in persons with dementia but is not associated with an increased risk of dementia over time.
研究视网膜病变与痴呆风险之间的关系。
我们在 Rotterdam 研究中，通过横断面和前瞻性研究，调查了视网膜病变与痴呆及其亚型阿尔茨海默病（AD）和血管性痴呆之间的关系。该研究为一项大型基于人群的队列研究，在基线时（1990-1993 年）有 195 名患有显性痴呆症的参与者和 6078 名没有痴呆症的参与者可提供数字化视网膜图像。参与者于 1993-1994 年、1997-1999 年和 2002-2004 年接受了重新检查，并一直监测至 2007 年 1 月 1 日痴呆症的发展情况。在眼底照片上对视网膜病变进行分级，并将其定义为存在一个或多个点/斑状出血、微动脉瘤、棉绒斑或视网膜病变激光治疗的证据。
视网膜病变与显性痴呆症相关（年龄和性别调整后的优势比为 2.04，95%置信区间[CI]为 1.34-3.09）。AD 和血管性痴呆症的结果相似。在平均 11.4 年的随访期间，735 名参与者发生了新发痴呆症，其中 583 名患有 AD，80 名患有血管性痴呆症。在随访期间，基线时的视网膜病变与新发痴呆症的风险（年龄和性别调整后的风险比为 1.15，95%CI 为 0.88-1.48）或新发 AD 或血管性痴呆症的风险无关。
视网膜病变在痴呆症患者中更为普遍，但与随时间推移痴呆症风险的增加无关。
