Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland.
BMC Neurol. 2021 Mar 11;21(1):112. doi: 10.1186/s12883-021-02137-4.
The retinal and cerebral microvasculature share similar embryological origins and physiological characteristics. Improved imaging technologies provide opportunistic non-invasive assessment of retinal microvascular parameters (RMPs) against cognitive outcomes. We evaluated baseline measures for associations between RMPs and mild cognitive impairment (MCI) from participants of the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA).
RMPs (central retinal arteriolar / venular equivalents, arteriole to venular ratio, fractal dimension and tortuosity) were measured from optic disc centred fundus images and analysed using semi-automated software. Associations between RMPs and MCI were assessed by multivariable logistic regression with adjustment for potential confounders including age, sex, alcohol consumption, smoking status, educational attainment, physical activity, cardiovascular disease (CVD), hypertension, mean arterial blood pressure, triglycerides, diabetes, body mass index, and high density lipoprotein levels. P < 0.05 was considered statistically significant.
Data were available for 1431 participants, of which 156 (10.9%) were classified with MCI defined by a Montreal Cognitive Assessment (MoCA) score ≤ 26, with subjective cognitive decline, in the absence of depression or problems with activities of daily living. Participants had a mean age of 62.4 ± 8.5 yrs. and 52% were female. As expected, individuals with MCI had a lower MoCA score than those without (23.5 ± 2.6 versus 26.3 ± 2.7, respectively), were more likely to be female, have a lower level of educational attainment, be less physically active, more likely to have CVD, have higher levels of triglycerides and lower levels of high density lipoprotein. No significant associations between RMPs and MCI were detected in unadjusted, minimally adjusted or fully adjusted regression models or subsequent sensitivity analyses.
Previous studies have reported both increased retinal venular calibre and reduced fractal dimension in association with mild cognitive impairment. Our study failed to detect any associations between RMPs and those individuals at an early stage of cognitive loss in an older community-based cohort.
视网膜和脑微血管具有相似的胚胎起源和生理特征。改进的成像技术提供了机会性的非侵入性评估视网膜微血管参数（RMP）与认知结果的关系。我们评估了北爱尔兰老龄化纵向研究（NICOLA）参与者的基线指标，以评估 RMP 与轻度认知障碍（MCI）之间的关系。
使用半自动软件从视盘中心的眼底图像中测量 RMP（视网膜中央动脉/静脉等效物、动静脉比、分形维数和扭曲度）。使用多变量逻辑回归评估 RMP 与 MCI 之间的关系，并进行了潜在混杂因素的调整，包括年龄、性别、饮酒、吸烟状况、教育程度、身体活动、心血管疾病（CVD）、高血压、平均动脉血压、甘油三酯、糖尿病、体重指数和高密度脂蛋白水平。P<0.05 被认为具有统计学意义。
共有 1431 名参与者的数据可用，其中 156 名（10.9%）根据蒙特利尔认知评估（MoCA）评分≤26 定义为 MCI，有主观认知下降，但无抑郁或日常生活活动问题。参与者的平均年龄为 62.4±8.5 岁，52%为女性。正如预期的那样，MCI 患者的 MoCA 评分低于非 MCI 患者（分别为 23.5±2.6 和 26.3±2.7），女性更多，教育程度更低，身体活动水平更低，更有可能患有 CVD，甘油三酯水平更高，高密度脂蛋白水平更低。在未调整、最小调整或完全调整的回归模型或随后的敏感性分析中，均未发现 RMP 与 MCI 之间存在显著关联。
先前的研究报告称，视网膜静脉口径增加和分形维数降低与轻度认知障碍有关。我们的研究未能在一个老年社区为基础的队列中检测到任何与 RMP 与那些处于认知丧失早期阶段的个体之间的关联。
