Eye Determinants of Cognition (EyeDOC) Study

项目总结 认知的眼睛决定因素(EyeDOC)研究 理论基础：痴呆症和轻度认知障碍(MCI)在我们的 美国人口老龄化。虽然众所周知，脑神经丧失会导致阿尔茨海默氏症，但血管 疾病可能在很大程度上造成痴呆症及其前驱疾病MCI的总负担。小船 与认知障碍关系最密切的脑血管变化很难检测到。 通过脑部成像。然而，眼部相干断层扫描(OCT)的最新技术进步提供了 视网膜神经节细胞微血管病理和神经变性的改进措施可能 提供反映潜在大脑过程的敏感生物标志物。 设计：EyeDOC研究将嵌套在社区动脉粥样硬化风险神经认知研究中 (ARIC-NCS)，从两个ARIC-NCS外地地点(杰克逊)招募1,000名参与者(50%非裔美国人) MS和马里兰州华盛顿县)参加一项全面的视力评估，包括摄影和 视网膜的OCT成像。EyeDOC访问将在ARIC NCS访问6之后的3个月内进行，并在 Aric NCS访问7，利用这项研究的广泛神经认知测试和纵向设计。 曝光：EyeDOC将为丰富的ARIC NCS数据提供新的眼部测量方法，包括： A.以黄斑神经节细胞复合体丢失/变薄为标志的神经退行性变程度[GCC] 视神经头外的视网膜神经纤维层[NFL] B.微血管病变程度以黄斑血管密度降低、面积扩大为特征 黄斑无血流灌注，平均黄斑血流量降低[血流指数]。 结果：ARIC-NCS的晚年认知结果包括： A.全球认知能力、执行功能/处理速度、记忆力和语言能力下降- 使用V5、V6和V7的神经认知测试进行评估。 B.MCI的发病率，在V5的队列中约有20%被诊断为MCI，预计 由于队列年龄的增加，在V6和V7影响更大的百分比。 目的：我们将评估1)视网膜神经退行性改变措施与MCI事件和 与阿尔茨海默病和2)视网膜微血管异常相一致的认知功能减退模式 与MCI和认知功能减退的模式符合脑部小血管疾病。因此， 主要焦点将是NFL变薄对记忆力下降的影响以及毛细血管减少的影响 血流和非灌注区的执行功能/处理速度下降。 摘要：EyeDOC的研究将展示视网膜生物标记物在揭示糖尿病病因方面的潜力。 观察到认知变化，并为OCT用作有效筛查提供概念证明 认知老化根本原因的确定工具(S)。

PROJECT SUMMARY Eye Determinants of Cognition (EyeDOC) Study Rationale: Dementia and mild cognitive impairment (MCI) pose enormous health and societal costs in our aging US population. While cerebral neural loss is known to contribute to Alzheimer's dementia, vascular diseases may contribute substantially to the total burden of dementia and its precursor, MCI. Small-vessel cerebrovascular changes, which are most strongly associated with cognitive impairments, are difficult to detect with brain imaging. However, recent technological advances in ocular coherence tomography (OCT) provide refined measures of the microvascular pathology and neurodegeneration of retinal ganglion cells which may provide sensitive biomarkers reflecting underlying cerebral processes. Design: The EyeDOC study will be nested in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), recruiting 1,000 participants (50% African-American) from two ARIC-NCS field sites (Jackson MS and Washington County, MD) to take part in a comprehensive vision assessment with photographic and OCT imaging of the retina. The EyeDOC visit will occur within 3 months of the ARIC NCS visit 6, and prior to ARIC NCS visit 7, capitalizing on the study's extensive neurocognitive testing and longitudinal design. Exposures: EyeDOC will contribute novel ocular measures to the rich ARIC NCS data including: A. Degree of neurodegeneration marked by loss/thinning of the macular ganglion cell complex [GCC] and the retinal nerve fiber layer [NFL] just outside the optic nerve head B. Degree of microvascular pathology marked by a lower macular vessel density, enlarged area of macular non-perfusion and lower average macular blood flow [flow index]. Outcomes: The late life cognitive outcomes available from ARIC-NCS include: A. Decline in global cognitive ability, executive function/processing speed, memory, and language – assessed using neurocognitive testing in V5, V6 and V7. B. Incidence of MCI, which was diagnosed in approximately 20% of the cohort in V5 and is expected to affect a larger percentage at V6 and V7 due to advancing age of the cohort. Aims: We will assess the relationships of 1) retinal neurodegenerative measures with incident MCI and a pattern of cognitive decline consistent with Alzheimer's disease and 2) retinal microvascular abnormalities with incident MCI and a pattern of cognitive decline consistent with cerebral small vessel disease. Thus, the primary focus will be the impact of NFL thinning on a decline in memory and the impact of reduced capillary blood flow and non-perfusion area on a decline in executive function/processing speed. Summary: The EyeDOC study will demonstrate the potential of retinal biomarkers to inform the etiology of observed cognitive changes and provide a proof of concept for OCT to be used as an effective screening tool for determining the underlying cause(s) of cognitive aging.