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Stroke. 2011 Jun;42(6):1589-95. doi: 10.1161/STROKEAHA.110.605261. Epub 2011 Apr 14.

Retinal microvascular signs and functional loss in older persons: the cardiovascular health study.

Author information

1
Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA. dkim2@bidmc.harvard.edu

Abstract

BACKGROUND AND PURPOSE:

We hypothesized that retinal microvascular signs are associated with executive dysfunction, slow gait, and depressive mood, which are characteristic features of microvascular disease affecting frontal subcortical regions of the brain.

METHODS:

In the Cardiovascular Health Study, 1744 participants (mean age, 78) free of stroke had retinal photographs and carotid ultrasound during the 1997 to 1998 visit. We examined the cross-sectional association of retinal signs with the digit-symbol substitution test (DSST) score, gait speed, the Center for Epidemiologic Studies-Depression score, and depressive mood, defined as Center for Epidemiologic Studies-Depression score >9 or antidepressant use.

RESULTS:

After adjusting for potential confounders, retinal signs were associated with lower DSST score (generalized arteriolar narrowing and arteriovenous nicking), slower gait (retinopathy), and depressive mood (generalized arteriolar narrowing). A higher number of retinal signs was associated with lower DSST score (-0.76 and -2.79 points for 1 sign and ≥2 signs versus none; P<0.001) and slower gait (-0.009 and -0.083 m/s; P=0.047), but not with the square root of Center for Epidemiologic Studies-Depression score (0.079 and -0.208; P=0.072). In addition, coexistence of retinal signs (generalized arteriolar narrowing and arteriovenous nicking) and carotid atherosclerosis was associated with lower DSST score compared with either process alone (P for interaction <0.01). Notably, further adjustment for ventricular size, white matter disease, and infarcts on MRI did not attenuate the association.

CONCLUSIONS:

Retinal signs are associated with executive dysfunction and slow gait, and possibly with depressive mood, suggesting a common process involving small vessels.

PMID:
21493913
PMCID:
PMC3127407
DOI:
10.1161/STROKEAHA.110.605261
[Indexed for MEDLINE]
Free PMC Article

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