Relation of Age-Related Macular Degeneration and Cognitive Impairment in an Older Population

Pham, Tuan H.; Kifley, Annette; Mitchell, Paul; Wang, Jie Jin

doi:10.1159/000094984

Cited by 80 publications

(81 citation statements)

References 48 publications

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“…[5][6][7][8][9] After multivariate adjustment, they found no association between dementia (OR, 1.0; 95% CI, 0.6-1.7), AD (1.1; 0.6-2.1), or low modified MMSE (1.2; 0.8-1.9) and early AMD. By contrast, they did report a positive association between cognitive impairment based on digit symbol substitution test and early AMD (OR, 2.0; 95% CI, 1.3-3.1).…”

Section: Discussionmentioning

confidence: 99%

Associations Between Age-Related Macular Degeneration, Alzheimer Disease, and Dementia

Keenan

Goldacre

2014

JAMA Ophthalmol

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IMPORTANCEThe potential association between age-related macular degeneration (AMD) and Alzheimer disease (AD) is uncertain and has implications for understanding disease pathogenesis, referral, and treatments.OBJECTIVES To determine whether individuals admitted to the hospital with AMD were significantly more or less likely to develop AD or dementia in the following years, as well as to assess whether people with AD or dementia were significantly more or less likely to be admitted to the hospital for AMD treatment in the years following diagnosis of dementia.

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Section: Discussionmentioning

confidence: 99%

Associations Between Age-Related Macular Degeneration, Alzheimer Disease, and Dementia

Keenan

Goldacre

2014

JAMA Ophthalmol

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“…[5][6][7][8] Although these studies used different cognitive tests ranging from crude global tests such as the mini-mental examination (MMS-E) to more sensitive tests such as the digit-symbol substitution test (DSST), the results indicate a relationship between poorer cognitive test results and AMD. However, the findings are weak and not consistent across different cognitive tests and across different studies.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] Cognitive function is the mental processes by which the brain acquires, processes, and acts upon information. Decline in cognitive function may be seen as a continuum from normal ageing to mild cognitive impairment and dementia.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive function, drusen, and age-related macular degeneration: a cross-sectional study

Lindekleiv

Erke

Bertelsen

et al. 2013

Eye

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Purpose To examine the cross-sectional relationship between drusen, late age-related macular degeneration (AMD), and cognitive function. Methods We included 2149 stroke-free participants from the population-based Tromsø Study in Norway. Retinal photographs were graded for presence of drusen and AMD. Cognitive function was assessed using the verbal memory test (short verbal memory), digit-symbol coding test (processing speed), and the tapping test (psychomotor tempo). We assessed the relationship between drusen, late AMD, and cognitive test scores, adjusted for potential confounders. Results Late AMD was associated with decreased performance in the verbal memory test (standardized b ¼ À 0.23, 95% confidence interval (CI): À 0.51 to À 0.01). Intermediate and large drusen were associated with decreased performance in the digit-symbol coding test (standardized b ¼ À 0.14 and -0.19, 95% CIs: À 0.23 to À 0.05 and À 0.29 to À 0.09, respectively). Participants with large drusen were more likely to have test scores in the lowest quartile of the digit-symbol coding test (odds ratio (OR) ¼ 1.9, 95% CI: 1.1-3.5) and the tapping test (OR ¼ 1.6, 95% CI: 1.0-2.6), but not in the verbal memory test (OR ¼ 1.0, 95% CI: 0.6-1.6). Conclusions The findings suggest a relationship between drusen deposition and reduced cognitive function. Although the relationships between drusen, late AMD, and the cognitive test results varied in strength and significance across the types of cognitive test, and may partly have been caused by residual confounding, it is not unlikely that a genuine but weaker relationship exists between drusen deposition and cognitive decline.

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“…230 This was resonated in people with ARM in the Cardiovascular Health Study (OR 1.38), 231 a weak association in another study (OR 1.6 for ARM) 232 and in people with AMD in an Australian population (OR 2.2). 233 The Rotterdam study demonstrated that tobacco and atherosclerosis may play a role in the pathogenesis of both ARMD and Alzheimer's disease. 234 Amyloid beta peptide is found in the neuritic plaques in…”

Section: Cognitive Impairmentmentioning

confidence: 99%

Risk Factors for Age-related Macular Degeneration

Berrow¹,

Bartlett²,

Eperjesi³

et al. 2011

European Ophthalmic Review

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Age-related macular disease (ARMD) is a degenerative disease of the macula, most common over the age of 50 years.1 It is the leading cause of visual loss within western industrialised countries. [2][3][4] The number of blind registrations attributable to the disease increased by 30-40 % between 1950 and 1990 3 and the number of cases each year is continuing to rise 4-6 as these populations have an increasing longevity. Definition of Age-related Macular DiseaseThe international age-related maculopathy group has defined an international classification system for quantifying and defining the different subgroups of ARMD in an attempt to permit easier comparison of research findings between groups.1 Age-related maculopathy (ARM) is a disorder of the macular area most apparent after age 50 and is characterised by the following:• Areas of drusen which are external to the neuroretina and retinal pigment epithelium (RPE). They are soft and distinct or soft and indistinct. Hard drusen are not characteristic of ARM. Drusen are discrete white-yellow spots containing abnormal extracellular lipoprotein deposits that accumulate between the RPE basal lamina and the inner collagenous layer of Bruch's membrane. 7• Hyperpigmentation in the outer retina or choroid with drusen.• Hypopigmentation of the RPE with drusen.This early stage of the condition may not affect vision, but can predispose patients to visual loss (see Figure 1).Later stages of the condition are classified as 'wet' or 'dry' age-related macular degeneration (AMD). These forms of the disease can occur with or without the involvement of new blood vessel growth. If new vessels are not involved (dry AMD), clinical presentation is a sharply defined round or oval area of hypopigmentation where choroidal vessels are more visible than the surrounding area, with a diameter greater than 175 μm 1 (see Figure 2). This is also known as geographic atrophy (GA).The term 'wet AMD', also known as disciform AMD, exudative AMD or neovascular AMD refers to the development of choroidal neovascularisation (see Figure 3) and has numerous manifestations, including:• choroidal neovascularisation (CNV);• RPE detachment(s);• subretinal or sub-RPE neovascular membrane(s);• deposition of scarring, glial tissue or fibrin-like material within the epiretinal, intraretinal, subretinal or sub-RPE layers;• subretinal haemorrhages (without other retinal vascular cause); and• hard exudates (formed from lipid) associated with the above manifestations (without other retinal vascular cause).This article uses the terms ARM, AMD and ARMD as per the international classification system described. Physiology of Age-related Macular DiseaseThe RPE rests on Bruch's membrane and separates the neural retina from the choriocapillaris. The RPE phagocytoses the outer segment discs of the photoreceptors and is a point of metabolite and waste exchange, which is considered crucial to retinal function. 8 The initial signs of ARMD are variations within and below the RPE, seen as alterations in the pigmentation of the ...

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Relation of Age-Related Macular Degeneration and Cognitive Impairment in an Older Population

Cited by 80 publications

References 48 publications

Associations Between Age-Related Macular Degeneration, Alzheimer Disease, and Dementia

Associations Between Age-Related Macular Degeneration, Alzheimer Disease, and Dementia

Cognitive function, drusen, and age-related macular degeneration: a cross-sectional study

Risk Factors for Age-related Macular Degeneration

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