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Additional evidence shown for role of microvascular disease in age-related disability
Arch Ophthalmol. 2011;doi:10.1001/archophthalmol.2011.360.
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A study provided further support for the pathophysiologic and prognostic importance of microvascular disease in age-related disability.
"Our study supports the hypothesis that microvascular disease accelerates age-related disability and retinal signs can be useful in understanding mechanisms and predicting outcomes," the authors wrote.
The prospective cohort study assessed 1,487 patients in the Cardiovascular Health Study who did not have age-related disability at their initial visit between 1998 and 1999. Patients were followed for a mean of 3.1 years, and disability was defined as any self-reported difficulty in executing activities of daily living.
Patients with two or more retinal signs were linked to a higher rate of disability than those with fewer signs (P < .001). This occurred independently of vascular risk factors and carotid atherosclerosis, even among participants without diabetes or cardiovascular disease, implicating retinal signs as a potential preclinical marker that may precede major risk factors.
Lack of significant interaction between retinal signals and carotid atherosclerosis, which was defined as carotid intima-media thickness at least in the 80th percentile or 25% or more stenosis, suggests a complex process leading to disability that encompasses cognitive and physical impairment, the study authors said.
They added that the correlation between retinal signs and disability seemed to be somewhat explained by executive dysfunction, slow gait and depressive symptoms.