You are here
Retinal microvascular signs and disability in the Cardiovascular Health Study.
Tuesday,2012-11-06 12:26 America/Los_Angeles — eenright
| Title | Retinal microvascular signs and disability in the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2012 |
| Authors | Kim, DHyun, Chaves, PHM, Newman, AB, Klein, R, Sarnak, MJ, Newton, E, Strotmeyer, ES, Burke, GL, Lipsitz, LA |
| Journal | Arch Ophthalmol |
| Volume | 130 |
| Issue | 3 |
| Pagination | 350-6 |
| Date Published | 2012 Mar |
| ISSN | 1538-3601 |
| Keywords | Activities of Daily Living, Aged, Carotid Artery Diseases, Cognition Disorders, Diagnostic Techniques, Ophthalmological, Disability Evaluation, Follow-Up Studies, Humans, Hypertension, Incidence, Kaplan-Meier Estimate, Microcirculation, Predictive Value of Tests, Prevalence, Prognosis, Prospective Studies, Retinal Diseases, Risk Factors, Smoking |
| Abstract | <p><b>OBJECTIVE: </b>To study the associations of retinal microvascular changes, which are associated with systemic conditions and cognitive decline, with disability in performing activities of daily living (ADL).</p><p><b>DESIGN: </b>Prospective cohort study of 1487 community-dwelling participants in the Cardiovascular Health Study (mean age, 78 years) who were free of ADL disability and had available data on retinal signs and carotid intima-media thickness at the 1998-1999 visit. Main outcome measures were incident ADL disability, defined as self-reported difficulty in performing any ADL, by the presence of retinal signs and advanced carotid atherosclerosis, defined by carotid intima-media thickness in the 80th percentile or more or 25% or more stenosis, and potential mediation by cerebral microvascular disease on brain imaging or by executive dysfunction, slow gait, and depressive mood, which are symptoms of frontal subcortical dysfunction.</p><p><b>RESULTS: </b>During the median follow-up of 3.1 years (maximum, 7.8 years), participants with 2 or more retinal signs had a higher rate of disability than those with fewer than 2 retinal signs (10.1% vs 7.1%; adjusted hazard ratio, 1.45; 95% confidence interval, 1.24-1.69; P < .001). There was no evidence of interaction by advanced carotid atherosclerosis (P > .10). The association seemed to be partially mediated by executive dysfunction, slow gait, and depressive symptoms but not by cerebral microvascular disease on brain imaging.</p><p><b>CONCLUSIONS: </b>These results provide further support for the pathophysiologic and prognostic significance of microvascular disease in age-related disability. However, it remains to be determined how to best use retinal photography in clinical risk prediction.</p> |
| DOI | 10.1001/archophthalmol.2011.360 |
| Alternate Journal | Arch. Ophthalmol. |
| PubMed ID | 22084159 |
| PubMed Central ID | PMC3520093 |
| Grant List | R01-AG-027002 / AG / NIA NIH HHS / United States P30 AG024827 / AG / NIA NIH HHS / United States R37-AG-25037 / AG / NIA NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States R56 AG020098 / AG / NIA NIH HHS / United States P01 AG004390 / AG / NIA NIH HHS / United States P30-AG-024827 / AG / NIA NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States AG-20098 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States R21-HL-077166 / HL / NHLBI NIH HHS / United States P30-AG-028717 / AG / NIA NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States P01 AG031720 / AG / NIA NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01 AG027002 / AG / NIA NIH HHS / United States R37 AG025037 / AG / NIA NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States R21 HL077166 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States R01-AG-023629 / AG / NIA NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States P30 AG028717 / AG / NIA NIH HHS / United States HL080295 / HL / NHLBI NIH HHS / United States P01-AG-004390 / AG / NIA NIH HHS / United States N01-HC-85239 / HC / NHLBI NIH HHS / United States AG-023629 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States P01-AG-031720 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |