Evaluation of retinal imaging as a biomarker of hypertensive effects on cognitive function

视网膜成像作为高血压对认知功能影响的生物标志物的评估

• 批准号: 10575915
• 负责人: Carrie Anne Karvonen-Gutierrez
• 金额: $ 24.99万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-15 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10575915
• 关键词: Activities of Daily Living; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Behavior; Biological Aging; Biological Factors; Biological Markers; Blood Chemical Analysis; Blood Pressure; Blood Vessels; Boston; Brain; Cardiovascular system; Caring; Central Nervous System; Clinical; Clinical assessments; Cognitive aging; Cohort Studies; Data; Data Set; Dementia; Digit structure; Drug Side Effects; Elderly; Evaluation; Event; Eye; Fundus; Future; Genetic Risk; Goals; Growth; Health; Heart; Heart Diseases; Hypertension; Hypertensive Retinopathy; Image; Impaired cognition; Individual; Inflammation; Inflammatory; Intervention; Kidney; Knowledge; Lesion; Life Style; Longitudinal Studies; Memory; Mental disorders; Michigan; Modality; Modeling; Myocardial Infarction; Optical Coherence Tomography; Optics; Organ; Pharmaceutical Preparations; Population; Prevalence; Prevention; Public Health; Publications; Race; Recording of previous events; Retina; Retinal Diseases; Risk; Sensitivity and Specificity; Standardization; Stroke; Study of Women' s Health Across the Nation; Surveys; Testing; Thick; Thinking; Treatment outcome; Vascular remodeling; Visit; Woman; Women' s Health; World Health Organization Disability Assessment Schedule; aging population; blood pressure control; blood pressure reduction; brain health; care providers; clinical examination; cognitive function; cognitive testing; cohort; demographics; design; digital; healthy aging; human old age (65+); hypertensive; improved; meetings; menopausal aging; middle age; mild cognitive impairment; nervous system disorder; ophthalmic examination; prevent; public health priorities; response; retinal imaging; retinal ischemia; secondary analysis; social; social factors; social health determinants; teleophthalmology; tomography; translational impact; vascular risk factor

ABSTRACT Mild cognitive impairment (MCI) represents a transition state between healthy cognitive aging and dementia. The estimated prevalence of MCI is 7% for individuals between 60-64 years old and increases to 25% for those 80-84 years old. There is a need to identify mechanisms that contribute to MCI with the aim of delaying the onset or preventing Alzheimer’s disease and other dementias. The 2020 Lancet Commission on dementia prevention, intervention, and care highlighted that midlife hypertension contributes to increased risk for MCI in late life. Signs of hypertension in the retinal microvessels indicate vascular re-modeling and this re-modeling is likely happening in the other end organs, such as the brain. There is a gap in knowledge on the relationship between hypertensive retinopathy and cognitive function decline during aging. The goal of our proposal is to fill this knowledge gap and advance understanding of the retinal microvessels as a biomarker of hypertensive effects on cognitive function. We hypothesize that hypertensive retinopathy is associated with lower cognitive function during aging. We will test this hypothesis with the existing data from the Michigan cohort of the Study of Women’s Health Across the Nation (SWAN-MI), which is an ongoing 27-year longitudinal study of women during the transition from midlife to early old age. The longitudinal data relevant for this proposal includes social determinants of health, cardiovascular parameters, cognitive tests, surveys, and selected blood chemistries. At the 2016/17 visit, a standardized eye exam and retina imaging that included digital fundus photographs and optical coherence tomography was performed on 215 women (age 66 ± 2.7 years; 61% black and 39% white). Using this unique, high-quality SWAN-MI dataset, the objectives of our secondary analyses include: a) characterizing the relationships between longitudinal cardiovascular data and hypertensive retinopathy assessed by clinical exam and retina imaging, and b) testing the association between hypertensive retinopathy and cognitive function during aging. We will test our hypothesis with two aims. Aim 1: Characterize microvascular features of hypertensive retinopathy and relationships with longitudinal cardiovascular data. Aim 2: Characterize the relationship between microvascular features in the retina with cognitive function during aging. Results from our proposed studies will contribute new knowledge about the hypertension-related mechanisms of dementia, one of public health and social care priorities worldwide with a rapid aging population. Furthermore, these studies may lead to the formation of integrated health networks that include teleophthalmology with retinal imaging and eye care providers to improve healthy aging.

抽象的 轻度认知障碍（MCI）代表健康认知衰老和痴呆症之间的过渡状态。 60-64岁的个体的MCI估计患病率为7％，增加到25％ 那些80-84岁。有必要确定有助于MCI的机制，以延迟 发病或预防阿尔茨海默氏病和其他痴呆症。 2020年柳叶刀痴呆委员会 预防，干预和护理强调，中年高血压有助于增加MCI的风险 晚年。视网膜微血管中高血压的迹象表明血管重新建模，并且这种重新模型为 可能发生在另一端器官，例如大脑。了解关系存在差距 在衰老期间高血压视网膜病变和认知功能下降之间。我们建议的目的是填补 这种知识差距并提高对视网膜微血管的理解，作为高血压的生物标志物 对认知功能的影响。我们假设高血压视网膜病与较低的认知有关 衰老期间的功能。我们将使用密歇根州同类的现有数据检验这一假设 全国妇女的健康（天鹅 - 米），这是一项持续的27年妇女纵向研究 从中年到老年的过渡期间。与该建议相关的纵向数据包括 健康的社会决定者，心血管参数，认知测试，调查和选定的血液 化学。在2016/17访问中，包括数字眼底的标准眼检查和视网膜成像 对215名女性进行摄影和光学相干断层扫描（66±2.7岁； 61％黑色 和39％的白色）。使用这个独特的高质量天鹅 - MI数据集，我们的次要分析的目标 包括：a）表征纵向心血管数据与高血压之间的关系 通过临床检查和视网膜成像评估的视网膜病，b）测试高血压之间的关联 衰老期间的视网膜病变和认知功能。我们将以两个目标检验我们的假设。目标1：特征 高血压视网膜病的微血管特征以及与纵向心血管数据的关系。 AIM 2：表征视网膜中微血管特征与认知功能之间的关系 老化。我们拟议的研究的结果将有助于有关高血压相关的新知识 痴呆机制，全球公共卫生和社会护理优先事项之一，迅速衰老 人口。此外，这些研究可能导致形成综合健康网络，包括 带有视网膜成像和眼保健提供者的电视疾病，以改善健康的衰老。