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Alzheimers Dement (Amst). 2018 Nov 12;11:19-27. doi: 10.1016/j.dadm.2018.10.006. eCollection 2019 Dec.

Retinal ganglion cell-inner plexiform layer thickness is nonlinearly associated with cognitive impairment in the community-dwelling elderly.

Author information

1
Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
2
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
3
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
4
Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
5
Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
6
Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
7
Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.

Abstract

Introduction:

Thinning of optical coherence tomography-measured retinal nerve fiber layer thickness and ganglion cell-inner plexiform layer (GC-IPL) thickness has been found in patients with Alzheimer's disease. However, the association of these retinal markers and cognition in nondemented elders may not be linear.

Methods:

This cross-sectional study included 227 community-dwelling elders (age 65+ years). Multivariable regression analyses were performed to investigate the association between retinal nerve fiber layer/GC-IPL and global/domain-specific cognition.

Results:

The performance of global cognition decreased as mean GC-IPL of bilateral eyes deviated from the sample mean (77.5 μm) (quadratic GC-IPL: β = -0.49 × 10-2; 95% confidence interval: -0.74 × 10-2 to -0.23 × 10-2). Similar associations were also found for logical memory. No significant association was observed between retinal nerve fiber layer and cognition.

Discussion:

Either thinning or thickening of GC-IPL was associated with poor cognition in nondemented elderly (a U-shaped association). GC-IPL may serve as a noninvasive preclinical predictor of Alzheimer's disease.

KEYWORDS:

Alzheimer's disease; Amyloid hypothesis; Biomarkers; Cognitive impairment; Dendritic pathology; GC-IPL; Ganglion cell–inner plexiform layer; OCT; Optical coherence tomography; Preclinical AD; RNFL; Retina; Retinal ganglion cell; Retinal nerve fiber layer; Synaptic dysfunction

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