Retinal Changes Tied to Impaired Daily Living Activities

Two or more retinal signs in older adults tied to lower ability to perform daily living activities

THURSDAY, Nov. 17 (HealthDay News) -- The presence of two or more retinal microvascular changes in community-dwelling older adults is associated with increased disability in performance of activities of daily living (ADL), according to a study published online Nov. 14 in the Archives of Ophthalmology.

Dae Hyun Kim, M.D., M.P.H., from the Harvard School of Public Health in Boston, and colleagues investigated the correlation between retinal microvascular changes and disability in performing ADL. Participants included 1,487 community-dwelling individuals (mean age of 78 years) from the Cardiovascular Health Study with available data on retinal signs and carotid intima-media thickness, and no ADL disability at the 1998 to 1999 baseline visit. Incident ADL was the main outcome measure during a median follow-up of 3.1 years.

The investigators found that, compared to participants with fewer than two retinal signs, those with two or more retinal signs had a significantly higher rate of disability during the follow-up (10.1 versus 7.1 percent; adjusted hazard ratio, 1.45). Neither individual retinal signs nor the presence of two or more retinal signs were significant for the interaction with carotid atherosclerosis. Executive dysfunction, slow gait, and depressive symptoms, but not cerebral microvascular disease on brain imaging, seemed to partially mediate the association.

"These results provide further support for the pathophysiologic and prognostic significance of microvascular disease in age-related disability," the authors write.

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