Original Research ARTICLE
A Potential Association Between Retinal Changes, Subjective Memory Impairment, and Anxiety in Older Adults at Risk for Alzheimer’s Disease: A 27-month Pilot Study.
- 1Alpert Medical School, Brown University, United States
- 2Department of Neurology, Warren Alpert Medical School of Brown University, United States
- 3University of Rhode Island, United States
Introduction: The utility of subjective memory impairment (SMI) as a risk marker for preclinical Alzheimer’s disease (AD) remains unclear; however, recent studies have identified a correlation between retinal biomarkers and onset of preclinical disease. This study examines the relationship between retinal biomarkers that have been associated with cerebral amyloid, an early hallmark of AD, and SMI scores in patients at risk for developing AD.
Methods: 49 cognitively-normal subjects were followed over 27 months and evaluated using a combination of neuropsychological, psychological, and retinal imaging instruments. Subjective memory testing was conducted using the Memory Assessment Clinic Questionnaire (MACQ) and Depression, Anxiety, and Stress Scales (DASS). Multivariate linear analysis was conducted using STATA software.
Results: Positive correlations were found between retinal nerve fiber layer (RNFL) volume and scores obtained from the MAC-Q at 27 months (MAC-Q_27), the DASS questionnaire for anxiety at 27 months (DASS-A_27), and the change in DASS-A over 27 months (dDASSA). There was also a significant positive correlation between these variables and the change in RNFL thickness over 27 months (dRNFL). MACQ_27, DASSA_27, and dDASS-A accounted for 35.7% of RFNL variance at 27 months and 21.5% of dRFNL variance.
Discussion: These findings suggest that worse subjective memory complaints and anxiety scores may be associated with one of the most commonly used structural anatomical retinal markers of early disease burden in AD. If so, these results lend support to SMI as a valid risk marker for later cognitive decline.
Keywords: Alzheimer's disease, Preclinical Alzheimer's disease, Subjective memory impairment (SMI), subjective cognitive decline (SCD), Retinal nerve fiber layer (RNFL), Retinal Biomarker
Received: 20 Mar 2019;
Accepted: 07 Oct 2019.
Copyright: © 2019 Cheng, Thompson and Snyder. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Peter J. Snyder, University of Rhode Island, Kingston, United States, email@example.com