Retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes: A GoDARTS study
ObjectivePatients with diabetes have an increased risk of dementia. Improved prediction of dementia is an important goal in developing future prevention strategies. Diabetic retinopathy screening (DRS) photographs may be a convenient source of imaging biomarkers of brain health. We therefore investi...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-08-01
|
| Series: | Frontiers in Digital Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fdgth.2022.945276/full |
| _version_ | 1828357151990480896 |
|---|---|
| author | Alexander S. F. Doney Aditya Nar Yu Huang Emanuele Trucco Tom MacGillivray Peter Connelly Graham P. Leese Gareth J. McKay on behalf of the INSPIRED consortium |
| author_facet | Alexander S. F. Doney Aditya Nar Yu Huang Emanuele Trucco Tom MacGillivray Peter Connelly Graham P. Leese Gareth J. McKay on behalf of the INSPIRED consortium |
| author_sort | Alexander S. F. Doney |
| collection | DOAJ |
| description | ObjectivePatients with diabetes have an increased risk of dementia. Improved prediction of dementia is an important goal in developing future prevention strategies. Diabetic retinopathy screening (DRS) photographs may be a convenient source of imaging biomarkers of brain health. We therefore investigated the association of retinal vascular measures (RVMs) from DRS photographs in patients with type 2 diabetes with dementia risk.Research Design and MethodsRVMs were obtained from 6,111 patients in the GoDARTS bioresource (635 incident cases) using VAMPIRE software. Their association, independent of Apo E4 genotype and clinical parameters, was determined for incident all cause dementia (ACD) and separately Alzheimer's disease (AD) and vascular dementia (VD). We used Cox’s proportional hazards with competing risk of death without dementia. The potential value of RVMs to increase the accuracy of risk prediction was evaluated.ResultsIncreased retinal arteriolar fractal dimension associated with increased risk of ACD (csHR 1.17; 1.08–1.26) and AD (HR 1.33; 1.16–1.52), whereas increased venular fractal dimension (FDV) was associated with reduced risk of AD (csHR 0.85; 0.74–0.96). Conversely, FDV was associated with increased risk of VD (csHR 1.22; 1.07–1.40). Wider arteriolar calibre was associated with a reduced risk of ACD (csHR 0.9; 0.83–0.98) and wider venular calibre was associated with a reduced risk of AD (csHR 0.87; 0.78–0.97). Accounting for competing risk did not substantially alter these findings. RVMs significantly increased the accuracy of prediction.ConclusionsConventional DRS photographs could enhance stratifying patients with diabetes at increased risk of dementia facilitating the development of future prevention strategies. |
| first_indexed | 2024-04-14T03:11:56Z |
| format | Article |
| id | doaj.art-ca6d477f298741fe8dbe04650ae16dc0 |
| institution | Directory Open Access Journal |
| issn | 2673-253X |
| language | English |
| last_indexed | 2024-04-14T03:11:56Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Digital Health |
| spelling | doaj.art-ca6d477f298741fe8dbe04650ae16dc02022-12-22T02:15:35ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2022-08-01410.3389/fdgth.2022.945276945276Retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes: A GoDARTS studyAlexander S. F. Doney0Aditya Nar1Yu Huang2Emanuele Trucco3Tom MacGillivray4Peter Connelly5Graham P. Leese6Gareth J. McKay7on behalf of the INSPIRED consortiumPopulation Health and Genomics, University of Dundee, Dundee, United KingdomPopulation Health and Genomics, University of Dundee, Dundee, United KingdomPopulation Health and Genomics, University of Dundee, Dundee, United KingdomVAMPIRE project, Computing, School of Science and Engineering, University of Dundee, Dundee, United KingdomVAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United KingdomNHS Tayside; NHS Research Scotland Neuroprogressive Disorders and Dementia Research Network, Ninewells Hospital Dundee; University of Dundee, Dundee, ScotlandPopulation Health and Genomics, University of Dundee, Dundee, United KingdomCentre for Public Health, Queen’s University Belfast, Belfast, NIR, United KingdomObjectivePatients with diabetes have an increased risk of dementia. Improved prediction of dementia is an important goal in developing future prevention strategies. Diabetic retinopathy screening (DRS) photographs may be a convenient source of imaging biomarkers of brain health. We therefore investigated the association of retinal vascular measures (RVMs) from DRS photographs in patients with type 2 diabetes with dementia risk.Research Design and MethodsRVMs were obtained from 6,111 patients in the GoDARTS bioresource (635 incident cases) using VAMPIRE software. Their association, independent of Apo E4 genotype and clinical parameters, was determined for incident all cause dementia (ACD) and separately Alzheimer's disease (AD) and vascular dementia (VD). We used Cox’s proportional hazards with competing risk of death without dementia. The potential value of RVMs to increase the accuracy of risk prediction was evaluated.ResultsIncreased retinal arteriolar fractal dimension associated with increased risk of ACD (csHR 1.17; 1.08–1.26) and AD (HR 1.33; 1.16–1.52), whereas increased venular fractal dimension (FDV) was associated with reduced risk of AD (csHR 0.85; 0.74–0.96). Conversely, FDV was associated with increased risk of VD (csHR 1.22; 1.07–1.40). Wider arteriolar calibre was associated with a reduced risk of ACD (csHR 0.9; 0.83–0.98) and wider venular calibre was associated with a reduced risk of AD (csHR 0.87; 0.78–0.97). Accounting for competing risk did not substantially alter these findings. RVMs significantly increased the accuracy of prediction.ConclusionsConventional DRS photographs could enhance stratifying patients with diabetes at increased risk of dementia facilitating the development of future prevention strategies.https://www.frontiersin.org/articles/10.3389/fdgth.2022.945276/fullretinal biomarkersdementia risk predictionVAMPIRE retinal image softwarediabetesdementia |
| spellingShingle | Alexander S. F. Doney Aditya Nar Yu Huang Emanuele Trucco Tom MacGillivray Peter Connelly Graham P. Leese Gareth J. McKay on behalf of the INSPIRED consortium Retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes: A GoDARTS study Frontiers in Digital Health retinal biomarkers dementia risk prediction VAMPIRE retinal image software diabetes dementia |
| title | Retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes: A GoDARTS study |
| title_full | Retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes: A GoDARTS study |
| title_fullStr | Retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes: A GoDARTS study |
| title_full_unstemmed | Retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes: A GoDARTS study |
| title_short | Retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes: A GoDARTS study |
| title_sort | retinal vascular measures from diabetes retinal screening photographs and risk of incident dementia in type 2 diabetes a godarts study |
| topic | retinal biomarkers dementia risk prediction VAMPIRE retinal image software diabetes dementia |
| url | https://www.frontiersin.org/articles/10.3389/fdgth.2022.945276/full |
| work_keys_str_mv | AT alexandersfdoney retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy AT adityanar retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy AT yuhuang retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy AT emanueletrucco retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy AT tommacgillivray retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy AT peterconnelly retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy AT grahampleese retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy AT garethjmckay retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy AT onbehalfoftheinspiredconsortium retinalvascularmeasuresfromdiabetesretinalscreeningphotographsandriskofincidentdementiaintype2diabetesagodartsstudy |