Association between retinal markers and cognition in older adults: a systematic review
Objectives To appraise the existing literature reporting an association between retinal markers and cognitive impairment in adults aged 65 years and over and to provide directions for future use of retinal scanning as a potential tool for dementia diagnosis.Design Systematic review of peer-reviewed...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e054657.full |
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| author | Gerald Liew Bamini Gopinath Joyce Chan Joyce Siette Varshanie Jeevakumar Rebekah Sefton Tejal M Shah |
| author_facet | Gerald Liew Bamini Gopinath Joyce Chan Joyce Siette Varshanie Jeevakumar Rebekah Sefton Tejal M Shah |
| author_sort | Gerald Liew |
| collection | DOAJ |
| description | Objectives To appraise the existing literature reporting an association between retinal markers and cognitive impairment in adults aged 65 years and over and to provide directions for future use of retinal scanning as a potential tool for dementia diagnosis.Design Systematic review of peer-reviewed empirical articles investigating the association of retinal markers in assessing cognitive impairment.Data sources Three electronic databases, Medline, PsycINFO and EMBASE were searched from inception until March 2022.Eligibility criteria All empirical articles in English investigating the association between retinal markers and cognition in humans aged ≥65 years using various retinal scanning methodologies were included. Studies with no explicit evaluation of retinal scanning and cognitive outcomes were excluded. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool.Data extraction and synthesis Data extraction was conducted by two authors (VJ, RS) and reviewed by another author (JS). Results were synthesised and described narratively.Results Sixty-seven eligible studies examining 6815 older adults were included. Majority of studies were cross-sectional (n=60; 89.6%). Optical coherence tomography (OCT) was the most commonly used retinal scanning methodology to measure the thickness of retinal nerve fibre layer, the ganglion cell complex, choroid and macula. 51.1% of cross-sectional studies using OCT reported an association between the thinning of at least one retinal parameter and poor cognition. Longitudinal studies (n=6) using OCT also mostly identified significant reductions in retinal nerve fibre layer thickness with cognitive decline. Study quality was overall moderate.Conclusion Retinal nerve fibre layer thickness is linked with cognitive performance and therefore may have the potential to detect cognitive impairment in older adults. Further longitudinal studies are required to validate our synthesis and understand underlying mechanisms before recommending implementation of OCT as a dementia screening tool in clinical practice.PROSPERO registration number CRD42020176757. |
| format | Article |
| id | doaj-art-9fe996783e844e799c41936048d6e92d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-9fe996783e844e799c41936048d6e92d2025-01-24T14:35:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-054657Association between retinal markers and cognition in older adults: a systematic reviewGerald Liew0Bamini Gopinath1Joyce Chan2Joyce Siette3Varshanie Jeevakumar4Rebekah Sefton5Tejal M Shah6Centre for Vision Research, The University of Sydney, Sydney, New South Wales, Australia1 Westmead Institute for Medical Research, Westmead, New South Wales, AustraliaHKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong KongCentre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, AustraliaAustralian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, AustraliaMacquarie Medical School, Macquarie University, North Ryde, New South Wales, AustraliaObjectives To appraise the existing literature reporting an association between retinal markers and cognitive impairment in adults aged 65 years and over and to provide directions for future use of retinal scanning as a potential tool for dementia diagnosis.Design Systematic review of peer-reviewed empirical articles investigating the association of retinal markers in assessing cognitive impairment.Data sources Three electronic databases, Medline, PsycINFO and EMBASE were searched from inception until March 2022.Eligibility criteria All empirical articles in English investigating the association between retinal markers and cognition in humans aged ≥65 years using various retinal scanning methodologies were included. Studies with no explicit evaluation of retinal scanning and cognitive outcomes were excluded. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool.Data extraction and synthesis Data extraction was conducted by two authors (VJ, RS) and reviewed by another author (JS). Results were synthesised and described narratively.Results Sixty-seven eligible studies examining 6815 older adults were included. Majority of studies were cross-sectional (n=60; 89.6%). Optical coherence tomography (OCT) was the most commonly used retinal scanning methodology to measure the thickness of retinal nerve fibre layer, the ganglion cell complex, choroid and macula. 51.1% of cross-sectional studies using OCT reported an association between the thinning of at least one retinal parameter and poor cognition. Longitudinal studies (n=6) using OCT also mostly identified significant reductions in retinal nerve fibre layer thickness with cognitive decline. Study quality was overall moderate.Conclusion Retinal nerve fibre layer thickness is linked with cognitive performance and therefore may have the potential to detect cognitive impairment in older adults. Further longitudinal studies are required to validate our synthesis and understand underlying mechanisms before recommending implementation of OCT as a dementia screening tool in clinical practice.PROSPERO registration number CRD42020176757.https://bmjopen.bmj.com/content/12/6/e054657.full |
| spellingShingle | Gerald Liew Bamini Gopinath Joyce Chan Joyce Siette Varshanie Jeevakumar Rebekah Sefton Tejal M Shah Association between retinal markers and cognition in older adults: a systematic review BMJ Open |
| title | Association between retinal markers and cognition in older adults: a systematic review |
| title_full | Association between retinal markers and cognition in older adults: a systematic review |
| title_fullStr | Association between retinal markers and cognition in older adults: a systematic review |
| title_full_unstemmed | Association between retinal markers and cognition in older adults: a systematic review |
| title_short | Association between retinal markers and cognition in older adults: a systematic review |
| title_sort | association between retinal markers and cognition in older adults a systematic review |
| url | https://bmjopen.bmj.com/content/12/6/e054657.full |
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