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Comparative Study
. 2012 Mar 27;78(13):942-9.
doi: 10.1212/WNL.0b013e31824d9655. Epub 2012 Mar 14.

Cognitive function and retinal and ischemic brain changes: the Women's Health Initiative

M Haan  1 , M A Espeland, B E Klein, R Casanova, S A Gaussoin, R D Jackson, A E Millen, S M Resnick, J E Rossouw, S A Shumaker, R Wallace, K Yaffe; Women’s Health Initiative Memory Study and the Women’s Health Initiative Sight Exam
Collaborators, Affiliations
Comparative Study

Cognitive function and retinal and ischemic brain changes: the Women's Health Initiative

M Haan et al. Neurology. .

Abstract

Objective: To examine the association between retinopathy and cognitive decline or brain lesions and volumes in older women.

Methods: This study included 511 women aged 65 and older who were simultaneously enrolled in the Women's Health Initiative Memory Study and the Sight Examination Study. In this analysis, we examined the link between retinopathy, assessed using fundus photography (2000-2002), cognitive performance over time assessed by the modified Mini-Mental State Examination (3MSE) (1996-2007), and white matter hyperintensities and lacunar infarcts in the basal ganglia.

Results: Presence of retinopathy was associated with poorer 3MSE scores (mean difference = 1.01, SE: 0.43) (p = 0.019) over a 10-year follow-up period and greater ischemic volumes in the total brain (47% larger, p = 0.04) and the parietal lobe (68% larger, p = 0.01) but not with measures of regional brain atrophy.

Conclusions: The correspondence we found between retinopathy and cognitive impairment, along with larger ischemic lesion volumes, strengthens existing evidence that retinopathy as a marker of small vessel disease is a risk factor for cerebrovascular disease that may influence cognitive performance and related brain changes. Retinopathy may be useful as a clinical tool if it can be shown to be an early marker related to neurologic outcomes.

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Figures

Figure 1
Figure 1. Study timelines
3MSE = modified Mini-Mental State Examination; WHI = Women's Health Initiative; WHIMS = Women's Health Initiative Memory Study; WHIMS-MRI = Women's Health Initiative Memory Study–Magnetic Resonance Imaging Study; WHISE = Women's Health Initiative Sight Exam Study.
Figure 2
Figure 2. Modified Mini-Mental State Examination (3MSE) scores over time for women by retinopathy status at eye examination forward derived from an adjusted × mixed linear regression model
Covariate adjustment for age, clinical site, education, smoking, body mass index, hypertension, prior cardiovascular disease, diabetes, examination year, and Women's Health Initiative treatment assignment.
See this image and copyright information in PMC

Comment in

  • Is brain health in the eye of the beholder?
    Gottesman RF, Li G. Gottesman RF, et al. Neurology. 2012 Mar 27;78(13):936-7. doi: 10.1212/WNL.0b013e31824de2bc. Epub 2012 Mar 14. Neurology. 2012. PMID: 22422893 No abstract available.

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