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van de Kreeke JA, Legdeur N, Badissi M, Nguyen HT, Konijnenberg E, Tomassen J, Ten Kate M, den Braber A, Maier AB, Tan HS, Verbraak FD, Visser PJ. Ocular biomarkers for cognitive impairment in nonagenarians; a prospective cross-sectional study. BMC Geriatr 2020; 20:155. [PMID: 32345233 PMCID: PMC7189586 DOI: 10.1186/s12877-020-01556-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 04/13/2020] [Indexed: 12/03/2022] Open
Abstract
Background Ocular imaging receives much attention as a source of potential biomarkers for dementia. In the present study, we analyze these ocular biomarkers in cognitively impaired and healthy participants in a population aged over 90 years (= nonagenarian), and elucidate the effects of age on these biomarkers. Methods For this prospective cross-sectional study, we included individuals from the EMIF-AD 90+ study, consisting of a cognitively healthy (N = 67) and cognitively impaired group (N = 33), and the EMIF-AD PreclinAD study, consisting of cognitively healthy controls aged ≥60 (N = 198). Participants underwent Optical Coherence Tomography (OCT) and fundus photography of both eyes. OCT was used to asses total and individual inner retinal layer thickness in the macular region (Early Treatment Diabetic Retinopathy Study circles) as well as peripapillary retinal nerve fiber layer thickness, fundus images were analyzed with Singapore I Vessel Assessment to obtain 7 retinal vascular parameters. Values for both eyes were averaged. Differences in ocular biomarkers between the 2 nonagenarian groups were analyzed using linear regression, differences between the individual nonagenarian groups and controls were analyzed using generalized estimating equations. Results Ocular biomarkers did not differ between the healthy and cognitively impaired nonagenarian groups. 19 out of 22 ocular biomarkers assessed in this study differed between either nonagenarian group and the younger controls. Conclusion The ocular biomarkers assessed in this study were not associated with cognitive impairment in nonagenarians, making their use as a screening tool for dementing disorders in this group limited. However, ocular biomarkers were significantly associated with chronological age, which were very similar to those ascribed to occur in Alzheimer’s Disease.
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Affiliation(s)
- Jacoba A van de Kreeke
- Ophthalmology Department, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
| | - Nienke Legdeur
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Maryam Badissi
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - H Ton Nguyen
- Ophthalmology Department, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Elles Konijnenberg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jori Tomassen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mara Ten Kate
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anouk den Braber
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H Stevie Tan
- Ophthalmology Department, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Frank D Verbraak
- Ophthalmology Department, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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Velayutham V, Benitez-Aguirre PZ, Craig ME, Liew G, Wong TY, Jenkins AJ, Donaghue KC. Innovative technology shows impact of glycaemic control on peripheral retinal vessels in adolescents with type 1 diabetes. Diabetologia 2017; 60:2103-2110. [PMID: 28711971 DOI: 10.1007/s00125-017-4375-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/01/2017] [Indexed: 12/21/2022]
Abstract
AIMS/HYPOTHESIS Retinal imaging enables non-invasive microvasculature assessment; however, only central retinal vessels have been studied in type 1 diabetes. Peripheral smaller vessels have a major haemodynamic role and may differ from central vessels in their response to the diabetic milieu. We hypothesise that diabetes has a greater impact on peripheral retinal vessels vs central vessels. METHODS Retinal photographs from adolescents (n = 736; age 12-20 years) with type 1 diabetes were graded (Singapore I Vessel Assessment) with vessel calibres measured in the 'central zone' as central retinal arteriolar and venular equivalents (CRAE and CRVE, respectively) and the 'extended zone' as mean width of arterioles and venules (MWa and MWv, respectively). Multivariable linear regression was used to explore associations between vessel calibres and HbA1c, diabetes duration, sex and BP. RESULTS Mean ± SD age was 14.1 ± 1.5 years, HbA1c was 8.5 ± 1.3% (69.4 ± 14.1 mmol/mol) and median diabetes duration was 4.9 years (interquartile range 3.1-7.6 years). Wider MWa was associated with HbA1c (β 0.01 [95% CI 0.004, 0.03]), longer diabetes duration (0.07 [0.02, 0.13]) and higher systolic BP (0.04 [0.02, 0.05]). MWv was associated with HbA1c (0.02 [0.009, 0.03]) and higher systolic BP (0.04 [0.03, 0.06]). CRAE was associated with longer diabetes duration (0.93 [0.58, 1.28]) and higher systolic BP (-0.28 [-0.37, -0.19]). CRVE was associated with longer diabetes duration (0.91 [0.42, 1.41]) and higher systolic BP (-0.20 [-0.33, -0.07]). Girls had wider vessels (for all four calibre measurements). CONCLUSIONS/INTERPRETATION In adolescents with type 1 diabetes, higher HbA1c is associated with adverse changes to peripheral smaller retinal vessels but not central vessels. The predictive value of retinal vascular imaging should be evaluated using longitudinal data.
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Affiliation(s)
- Valli Velayutham
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Paul Z Benitez-Aguirre
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia
- Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Maria E Craig
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia
- Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
- School of Paediatrics, University of New South Wales, Sydney, NSW, Australia
| | - Gerald Liew
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia
- Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Tien Y Wong
- Department of Ophthalmology, University of Melbourne and Centre for Eye Research, East Melbourne, VIC, Australia
- Singapore Eye Research Institute, Singapore, Republic of Singapore
| | - Alicia J Jenkins
- Singapore Eye Research Institute, Singapore, Republic of Singapore
| | - Kim C Donaghue
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia.
- Singapore Eye Research Institute, Singapore, Republic of Singapore.
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