Retinopathy and risk of dementia: the Rotterdam Study.

To investigate the relation between retinopathy and the risk of dementia. We investigated the associations between retinopathy and dementia and its subtypes Alzheimer disease (AD) and vascular dementia both cross-sectionally and prospectively in the Rotterdam Study, a large population-based cohort study. Digitized retinal images were available for 195 participants with prevalent dementia and 6,078 participants without dementia at baseline (1990-1993). Participants were reexamined in 1993-1994, 1997-1999, and 2002-2004 and were continuously monitored for development of dementia until January 1, 2007. Retinopathy was graded on fundus photographs and was defined as the presence of one or more dot/blot hemorrhages, microaneurysms, cotton wool spots, or evidence of laser treatment for retinopathy. Retinopathy was associated with prevalent dementia (age and sex-adjusted odds ratio 2.04, 95% confidence interval [CI] 1.34-3.09). Results were similar for AD and vascular dementia. During a mean follow-up of 11.4 years, 735 participants developed incident dementia, of whom 583 had AD and 80 had vascular dementia. There was no association of retinopathy at baseline with the risk of incident dementia during follow-up (age- and sex-adjusted hazard ratio 1.15, 95% CI 0.88-1.48) or the risk of incident AD or vascular dementia. Retinopathy is more prevalent in persons with dementia but is not associated with an increased risk of dementia over time. AD: Alzheimer disease ARIC: Atherosclerosis Risk in Communities CI: confidence interval CRP: C-reactive protein DSM-III-TR: Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised GMS: Geriatric Mental State schedule MMSE: Mini-Mental State Examination OR: odds ratio.

• View at Publisher
• View at Pubmed
• View at Scopus
• View at Web of Science