Is early age-related maculopathy related to cognitive function? The Atherosclerosis Risk in Communities Study.
Is early age-related maculopathy related to cognitive function? The Atherosclerosis Risk in Communities Study.
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DOI：
10.1016/s0002-9394(02)01672-0
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发表时间：
2002-12
影响因子：
4.2
通讯作者：
T. Wong;R. Klein;F. Nieto;S. A. Moraes;T. Mosley;D. Couper;B. Klein;L. Boland;L. Hubbard;A. Sharrett
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文献类型：
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作者：
T. Wong;R. Klein;F. Nieto;S. A. Moraes;T. Mosley;D. Couper;B. Klein;L. Boland;L. Hubbard;A. Sharrett
PURPOSE老年性黄斑病变(ARM)和认知障碍都是与衰老相关的神经退行性疾病，并被假设为共同的致病途径。我们描述了中年人的认知功能与ARM之间的关系。设计基于人群的横断面研究，涉及社区动脉粥样硬化风险研究的参与者，这是一项正在进行的心血管调查，从1987年到1998年，每三年检查一次。方法访问三次(1993-1995)，获得视网膜照片，并使用改进的威斯康星ARM分级系统对ARM进行评估。在第二次访问(1990-1992年)和第四次访问(1996-1998年)时，使用标准化测试(延迟单词回忆、数字符号和单词流畅性)评估认知功能，并取平均值进行分析。严重认知障碍的定义是得分下降到人群中最低的10%。结果在排除中风患者或使用抗精神病药物后，9286人获得了TSData。在调整了年龄、性别、种族、教育程度、糖尿病、高血压、吸烟和饮酒后，基于单词流利性测试分数的严重认知损害的人比没有严重损害的人更有可能患有早期ARM(优势比[OR]：1.6，95%可信区间[CI]：1.1-2.2)及其组成部分、软性黄褐斑(OR：1.6；95%CI：1.1-2.3)和色素异常(OR：1.5；95%CI：0.9-2.5)。然而，其他两项认知功能测试得分中的严重认知损害与ARM无关。结论这些基于人群的数据表明，在中年人中，认知功能与早期ARM之间存在微弱的关联。
PURPOSEAge-related maculopathy (ARM) and cognitive impairment are both neurodegenerative disorders associated with aging and have been hypothesized to share common pathogenic pathways. We describe the association between cognitive function and ARM in middle-aged persons.DESIGNPopulation-based, cross-sectional study involving participants of the Atherosclerosis Risk in Communities Study, an ongoing cardiovascular investigation of persons 51 to 70 years of age, examined every 3 years between 1987 to 1998.METHODSAt visit three (1993–1995), retinal photographs were obtained and evaluated for ARM using a modification of the Wisconsin ARM Grading System. Cognitive function was assessed using standardized tests (Delayed Word Recall, Digit Symbol, and Word Fluency) at visits two (1990–1992) and four (1996–1998) and averaged for analysis. Severe cognitive impairment was defined as scores falling in the lowest 10th percentile of the population.RESULTSData were available in 9286 persons after exclusion of persons with stroke or using antipsychotic medication. After adjusting for age, gender, race, education, diabetes, hypertension, cigarette smoking, and alcohol consumption, persons with severe cognitive impairment based on Word Fluency Test scores were more likely to have early ARM (odds ratio [OR]: 1.6, 95% confidence interval [CI]: 1.1–2.2) and its components, soft drusen (OR: 1.6; 95% CI: 1.1–2.3) and pigmentary abnormality (OR: 1.5; 95% CI: 0.9–2.5) than those without severe impairment. However, severe cognitive impairment in scores of the other two cognitive function tests was not associated with ARM.CONCLUSIONThese population-based data suggest a weak association between cognitive function and early ARM in middle-aged persons.