Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Retinal Signs and Risk of Incident Dementia

Alzheimers Dement; ePub 2018 Nov 12; Deal, et al

Exploration of measures in the eye may provide surrogate indices of microvascular lesions relevant to dementia. In a population-based study of 12,482 adults aged 50-73 years (22% African American), researchers estimated the relationship of retinal characteristics from fundus photography (1993-1995) with incident all-cause dementia (1993-1995 to 2011-2013) and with etiologic subtype of dementia/mild cognitive impairment (2011-13). They found:

  • A total of 1,259 (10%) participants developed dementia over a mean 15.6 years.
  • Moderate/severe (vs no) retinopathy (hazard ratio [HR], 1.86) and central retinal arteriolar equivalent (narrowest quartile vs widest 3 quartiles; HR, 1.26) were associated with all-cause dementia.
  • Results were qualitatively stronger (but not statistically significantly different) in participants with diabetes.
  • Retinopathy was associated with a joint outcome of cerebrovascular-related, but not Alzheimer disease-related, dementia/mild cognitive impairment (HR, 2.29).


Deal JA, Sharrett AR, Albert M, et al. Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study. [Published online ahead of print November 12, 2018]. Alzheimers Dement. doi:10.1016/j.jalz.2018.10.002.

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