Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study

Jennifer A. Deal, A. Richey Sharrett, Marilyn Albert, Karen Bandeen-Roche, Sheila Burgard, Sonia Davis Thomas, Rebecca F. Gottesman, David Knopman, Thomas Mosley, Barbara Klein, Ronald Klein

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Introduction: The easily-imaged retinal microvasculature may reflect the brain microvasculature and therefore be related to dementia. Methods: In a population-based study of 12,482 adults aged 50-73 years (22% African American), we 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). Results: A total of 1259 (10%) participants developed dementia over a mean 15.6 years. Moderate/severe (vs. no) retinopathy (hazard ratio [HR], 1.86; 95% confidence interval [CI]: 1.36–2.55) and central retinal arteriolar equivalent (narrowest quartile vs. widest three quartiles; HR, 1.26; 95% CI: 1.09–1.45) 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's disease–related, dementia/mild cognitive impairment (HR, 2.29; 95% CI: 1.24–4.23). Discussion: Exploration of measures in the eye may provide surrogate indices of microvascular lesions relevant to dementia.

Original languageEnglish (US)
Pages (from-to)477-486
Number of pages10
JournalAlzheimer's and Dementia
Issue number3
StatePublished - Mar 2019


  • Cohort studies
  • Dementia
  • Diabetes
  • Microvasculature
  • Retinal
  • Risk factors in epidemiology

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Health Policy
  • Developmental Neuroscience
  • Epidemiology


Dive into the research topics of 'Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study'. Together they form a unique fingerprint.

Cite this