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Vision Disease May Signal Cognitive Decline

Women ages 65 and older with retinopathy may be more likely to experience cognitive decline and related vascular changes in the brain.

Women ages 65 or older who have even mild retinopathy, a disease of blood vessels in the retina of the eye, are more likely to have cognitive decline and related vascular changes in the brain.  Mary Haan, from the University of California, San Francisco (UCSF; California, USA), and colleagues followed 511 women, average age 69 years, for 10 years. Each year, the women took a cognition test focused on short-term memory and thinking processes. In the fourth year, they received an exam to assess eye health. In the eighth year, they received a brain scan. Of the full group of women, 39 women, or 7.6%, were diagnosed with retinopathy. On average, these women scored worse on the cognition test than the other women. They had more difficulty, for instance, recalling a list of several words five minutes after hearing them. The women with retinopathy also had more damage to the blood vessels of the brain. They had 47% more ischemic lesions, or holes, in the vasculature overall and 68% more lesions in the parietal lobe. The lesions, associated with vascular disease and sometimes stroke, are believed to be caused by high blood pressure. They also had more thickening of the white matter tracks that transmit signals in the brain, which also appear to be caused by high blood pressure.  Writing that: “The correspondence we found between retinopathy and cognitive impairment, along with larger ischemic lesion volumes, strengthens existing evidence that retinopathy as a marker of small vessel disease is a risk factor for cerebrovascular disease that may influence cognitive performance and related brain changes,” the study authors submit that:  “a relatively simple eye screening could serve as a marker for cognitive changes related to vascular disease, allowing for early diagnosis and treatment, potentially reducing the progression of cognitive impairment to dementia.”

M. Haan, M.A. Espeland, B.E. Klein, R. Casanova, K. Yaffe, and For the Women’s Health Initiative Memory Study and the Women’s Health Initiative Sight Exam. “Cognitive function and retinal and ischemic brain changes: The Women’s Health Initiative,” Neurology, March 27, 2012; 78:942-949.