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视网膜血管阻塞与痴呆症之间的关联。

Associations Between Retinal Vascular Occlusions and Dementia.

作者信息

Prasad Minali, Goodman Deniz, Gutta Sanhit, Sheikh Zahra, Cabral Howard J, Shunyakova Jenny, Sanjiv Nayan, Curley Cameron, Yarala Rohun Reddy, Tsai Lynna, Siegel Nicole H, Chen Xuejing, Poulaki Vasiliki, Alosco Michael L, Stein Thor D, Ness Steven, Subramanian Manju L

机构信息

Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA.

Department of Ophthalmology, Boston Medical Center, Boston, MA 02118, USA.

出版信息

Healthcare (Basel). 2024 Nov 26;12(23):2371. doi: 10.3390/healthcare12232371.

Abstract

BACKGROUND/OBJECTIVES: Retinal vascular occlusions, such as retinal vein occlusion (RVO) and retinal artery occlusion (RAO), are associated with cognitive impairment, including dementia. Our objective was to examine the odds of dementia among patients with retinal vascular occlusion.

METHODS

This cross-sectional study included 474 patients with retinal vascular occlusion and 948 patients without retinal vascular occlusion (comparison group). Patients in the comparison group were age- and sex-matched to those with vascular occlusion. Logistic regression was used to analyze the odds of all-cause dementia, vascular dementia, and Alzheimer's disease after adjusting for demographic, clinical, and ophthalmic covariates. Main outcome measures included the presence of all-cause dementia, vascular dementia, and Alzheimer's disease.

RESULTS

Patients with RVO (n = 413) had increased odds for all-cause dementia (odds ratio (OR) = 2.32; 95% confidence interval (CI): 1.44-3.75; < 0.001) and vascular dementia (OR = 3.29; 95% CI: 1.41-7.68; = 0.006) relative to the comparison group. Patients with central RVO (n = 192) (OR = 2.32; 95% CI: 1.19-4.54; = 0.014) or branch RVO (n = 221) (OR = 2.68; 95% CI: 1.30-5.50; = 0.007) had increased odds for all-cause dementia relative to the comparison group. Patients with RAO (n = 61) did not have increased odds of all-cause dementia (OR = 1.01; 95% CI: 0.32-3.26; = 0.983), vascular dementia (OR = 1.54; 95% CI: 0.22-10.81; = 0.663), or Alzheimer's disease (OR = 0.32; 95% CI: 0.05-2.20; = 0.244).

CONCLUSIONS

A history of any RVO is associated with increased rates of all-cause dementia and vascular dementia independent of shared cardiovascular risk factors. These associations are not seen with a history of RAO, or between any subtype of vascular occlusions and Alzheimer's disease.

摘要

背景/目的:视网膜血管阻塞,如视网膜静脉阻塞(RVO)和视网膜动脉阻塞(RAO),与包括痴呆症在内的认知障碍有关。我们的目的是研究视网膜血管阻塞患者患痴呆症的几率。

方法

这项横断面研究纳入了474例视网膜血管阻塞患者和948例无视网膜血管阻塞的患者(对照组)。对照组患者在年龄和性别上与血管阻塞患者相匹配。在对人口统计学、临床和眼科协变量进行调整后,使用逻辑回归分析全因痴呆、血管性痴呆和阿尔茨海默病的几率。主要结局指标包括全因痴呆、血管性痴呆和阿尔茨海默病的存在情况。

结果

与对照组相比,RVO患者(n = 413)患全因痴呆(优势比(OR)= 2.32;95%置信区间(CI):1.44 - 3.75;P < 0.001)和血管性痴呆(OR = 3.29;95% CI:1.41 - 7.68;P = 0.006)的几率增加。中心性RVO患者(n = 192)(OR = 2.32;95% CI:1.19 - 4.54;P = 0.014)或分支性RVO患者(n = 221)(OR = 2.68;95% CI:1.30 - 5.50;P = 0.007)患全因痴呆的几率相对于对照组增加。RAO患者(n = 61)患全因痴呆(OR = 1.01;95% CI:0.32 - 3.26;P = 0.983)、血管性痴呆(OR = 1.54;95% CI:0.22 - 10.81;P = 0.663)或阿尔茨海默病(OR = 0.32;95% CI:0.05 - 2.20;P = 0.244)的几率没有增加。

结论

任何RVO病史均与全因痴呆和血管性痴呆的发生率增加相关,且独立于共同的心血管危险因素。RAO病史或任何血管阻塞亚型与阿尔茨海默病之间未观察到这些关联。

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