Interocular retinal asymmetry and cognitive frailty: A prospective cohort study

Yung-Sung Lee; Yi-Ting Hsieh; Te-Hsuan Huang; Jeng-Min Chiou; Tao-Chun Peng; Yao-Lin Liu; Jen-Hau Chen; Yen-Ching Chen

doi:10.1002/alz.14437

Interocular retinal asymmetry and cognitive frailty: A prospective cohort study

Alzheimers Dement. 2024 Dec 23. doi: 10.1002/alz.14437. Online ahead of print.

Authors

Yung-Sung Lee^{1

2

3}, Yi-Ting Hsieh^{4

5}, Te-Hsuan Huang⁶, Jeng-Min Chiou^{7

8}, Tao-Chun Peng^{3

9

10}, Yao-Lin Liu⁴, Jen-Hau Chen^{11

12}, Yen-Ching Chen^{3

13}

Affiliations

¹ Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
² Department of Ophthalmology, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan.
³ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁴ Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
⁵ Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁶ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, United States.
⁷ Institute of Statistics and Data Science, National Taiwan University, Taipei, Taiwan.
⁸ Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
⁹ Division of Family Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan.
¹⁰ Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan.
¹¹ Department of Geriatrics and Gerontology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
¹² Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
¹³ Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.

PMID: 39711521
DOI: 10.1002/alz.14437

Abstract

Introduction: The retinal nerve fiber layer (RNFL) or ganglion cell-inner plexiform layer (GC-IPL) is associated with cognitive impairment. However, the relationship between retinal asymmetry and cognitive frailty (CF) remains unknown.

Methods: Two hundred twenty-two community-dwelling older adults were assessed starting in 2015 and underwent biennial cognitive and frailty evaluations until 2022. Retinal asymmetry was defined as the absolute interocular retinal difference. Generalized linear mixed models estimated the risk of CF over time.

Results: Among the participants, 158 completed the 4-year follow-up. Greater baseline GC-IPL asymmetry was associated with worsening CF over time (adjusted odds ratio = 1.06; 95% confidence interval [CI] = 1.03, 1.10), with handgrip strength asymmetry significantly modifying this association (p_interaction= 0.02). GC-IPL asymmetry was associated with cognitive impairment ( $\hat{β}$ = -1.69 × 10^-2; 95% CI = -3.13 × 10^-2, -0.25 × 10^-2) but not with physical frailty. RNFL showed no significant association with CF.

Discussion: Interocular GC-IPL asymmetry might be a new biomarker for CF in older adults.

Highlights: Interocular ganglion cell-inner plexiform layer (GC-IPL) asymmetry was associated with impaired memory-frailty, with handgrip strength asymmetry significantly modifying this association. Interocular GC-IPL asymmetry was associated with cognitive impairment. Interocular retinal asymmetry might be a structural biomarker of cognitive frailty.

Keywords: asymmetry; cognition; cognitive frailty; ganglion cell–inner plexiform layer; handgrip strength; older adults; physical frailty; retina; retinal nerve fiber layer.

Abstract

Grants and funding