Cognitive Function and Ophthalmological Diseases: The Beijing Eye Study

Jonas, Jost B; Wei, Wen Bin; Zhu, Li; Xu, Liang; Wang, Ya Xing

doi:10.1038/s41598-018-23314-5

Cited by 30 publications

(26 citation statements)

References 50 publications

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“…Furthermore, and perhaps even more interestingly, we found that patients with glaucoma had diffuse involvement of the white matter tracts in the prefrontal cortex [ 63 ], as well as in temporo-parietal regions. Although we did not test for cognitive impairment in our population, previous studies [ 7 , 8 , 9 , 10 ] have consistently described lower cognitive function in patients with glaucoma which was not merely related to the visual dysfunction per se. The link between glaucoma, cognitive decline, and healthy aging has been recently reported, although a clear pathophysiological framework to explain these associations is still lacking.…”

Section: Discussionmentioning

confidence: 87%

“…Visual impairment due to glaucoma affects daily living with wide-ranging implications in functional domains such as driving, walking, and reading [ 4 , 5 , 6 ]. Moreover, several studies have highlighted a possible connection between reductions of the visual field (VF) and a higher likelihood of developing cognitive impairment, both of which are common phenomena in glaucoma patients [ 7 , 8 , 9 , 10 ]. Interestingly, these observations are in keeping with recent findings supporting the hypothesis that glaucoma could be considered to be a neurodegenerative disorder involving the central nervous system (CNS) [ 4 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma

Nucci

Garaci

Altobelli

et al. 2020

JCM

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Glaucoma is an optic neuropathy characterized by death of retinal ganglion cells and loss of their axons, progressively leading to blindness. Recently, glaucoma has been conceptualized as a more diffuse neurodegenerative disorder involving the optic nerve and also the entire brain. Consistently, previous studies have used a variety of magnetic resonance imaging (MRI) techniques and described widespread changes in the grey and white matter of patients. Diffusion kurtosis imaging (DKI) provides additional information as compared with diffusion tensor imaging (DTI), and consistently provides higher sensitivity to early microstructural white matter modification. In this study, we employ DKI to evaluate differences among healthy controls and a mixed population of primary open angle glaucoma patients ranging from stage I to V according to Hodapp–Parrish–Anderson visual field impairment classification. To this end, a cohort of patients affected by primary open angle glaucoma (n = 23) and a group of healthy volunteers (n = 15) were prospectively enrolled and underwent an ophthalmological evaluation followed by magnetic resonance imaging (MRI) using a 3T MR scanner. After estimating both DTI indices, whole-brain, voxel-wise statistical comparisons were performed in white matter using Tract-Based Spatial Statistics (TBSS). We found widespread differences in several white matter tracts in patients with glaucoma relative to controls in several metrics (mean kurtosis, kurtosis anisotropy, radial kurtosis, and fractional anisotropy) which involved localization well beyond the visual pathways, and involved cognitive, motor, face recognition, and orientation functions amongst others. Our findings lend further support to a causal brain involvement in glaucoma and offer alternative explanations for a number of multidomain impairments often observed in glaucoma patients.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma

Nucci

Garaci

Altobelli

et al. 2020

JCM

View full text Add to dashboard Cite

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“…Epidemiological connections have also been determined between AD, glaucoma, and AMD. Both glaucoma and AMD also appear to be related to a decline in cognitive function, although it is unclear if subjects had other undetected co-existing underlying pathologies [ 11 , 12 , 13 , 14 ]. Patients who have glaucoma and AMD have been associated with an increased risk for AD [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Role of Retinal Amyloid-β in Neurodegenerative Diseases: Overlapping Mechanisms and Emerging Clinical Applications

Wang

Mao

2021

IJMS

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Amyloid-β (Aβ) accumulations have been identified in the retina for neurodegeneration-associated disorders like Alzheimer’s disease (AD), glaucoma, and age-related macular degeneration (AMD). Elevated retinal Aβ levels were associated with progressive retinal neurodegeneration, elevated cerebral Aβ accumulation, and increased disease severity with a decline in cognition and vision. Retinal Aβ accumulation and its pathological effects were demonstrated to occur prior to irreversible neurodegeneration, which highlights its potential in early disease detection and intervention. Using the retina as a model of the brain, recent studies have focused on characterizing retinal Aβ to determine its applicability for population-based screening of AD, which warrants a further understanding of how Aβ manifests between these disorders. While current treatments directly targeting Aβ accumulations have had limited results, continued exploration of Aβ-associated pathological pathways may yield new therapeutic targets for preserving cognition and vision. Here, we provide a review on the role of retinal Aβ manifestations in these distinct neurodegeneration-associated disorders. We also discuss the recent applications of retinal Aβ for AD screening and current clinical trial outcomes for Aβ-associated treatment approaches. Lastly, we explore potential future therapeutic targets based on overlapping mechanisms of pathophysiology in AD, glaucoma, and AMD.

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“…Since presbycusis affects more than 30% of the oldest-old, it stands to reason that greater adoption of this assistive device might have an effect on the functional ability of these individuals, and possibly cognition itself. Mirroring the data on hearing impairment, the adequate correction of refractive errors limiting visual acuity is associated with better cognitive function, but these data were obtained in a predominantly younger-old cohort [95]. It is commonly recommended that visually impaired and/or elderly individuals maintain adequate lighting in the home and remove objects such as rugs in order to prevent mechanical falls, but data regarding the efficacy of these modifications is minimal.…”

Section: Assistive Devices and Environment Modificationmentioning

confidence: 99%

Diagnosis and Management of Cognitive Concerns in the Oldest-Old

Borders

2021

Curr Treat Options Neurol

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Purpose of review The fastest-growing group of elderly individuals is the “oldest-old,” usually defined as those age 85 years and above. These individuals account for much of the rapid increase in cases of dementing illness throughout the world but remain underrepresented in the body of literature on this topic. The aim of this review is first to outline the unique contributing factors and complications that must be considered by clinicians in evaluating an oldest-old individual with cognitive complaints. Secondly, the evidence for management of these cognitive concerns is reviewed. Recent findings In addition to well-established associations between impaired cognition and physical disability, falls, and frailty, there is now evidence that exercise performed decades earlier confers a cognitive benefit in the oldest-old. Moreover, though aggressive blood pressure control is critical earlier in life for prevention of strokes, renal disease, and other comorbidities, hypertension started after age 80 is in fact associated with a decreased risk of clinical dementia, carrying significant implications for the medical management of oldest-old individuals. The oldest-old are more likely to reside in care facilities, where social isolation might be exacerbated by a consistently lower rate of internet-connected device use. The COVID-19 pandemic has not only highlighted the increased mortality rate among the oldest-old but has also brought the increased social isolation in this group to the forte. Summary Differing from the “younger-old” in a number of respects, the oldest-old is a unique population not just in their vulnerability to cognitive disorders but also in the diagnostic challenges they can pose. The oldest-old are more likely to be afflicted by sensory deficits, physical disability, poor nutrition, frailty, and depression, which must be accounted for in the assessment of cognitive complaints as they may confound or complicate the presentation. Social isolation and institutionalization are also associated with impaired cognition, perhaps as sequelae, precipitants, or both. Ante-mortem diagnostic tools remain particularly limited among the oldest-old, especially given the likelihood of these individuals to have multiple co-occurring types of neuropathology, and the presence of neuropathology in those who remain cognitively intact. In addition to the symptomatic treatments indicated for patients of all ages with dementia, management of cognitive impairment in the oldest-old may be further optimized by use of assistive devices, augmentation of dietary protein, and liberalization of medication regimens for risk factors such as hypertension.

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Cognitive Function and Ophthalmological Diseases: The Beijing Eye Study

Cited by 30 publications

References 50 publications

Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma

Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma

Role of Retinal Amyloid-β in Neurodegenerative Diseases: Overlapping Mechanisms and Emerging Clinical Applications

Diagnosis and Management of Cognitive Concerns in the Oldest-Old

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