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March 27, 2018; 90 (13) Article

Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study

Jennifer A. Deal, A. Richey Sharrett, Andreea M. Rawlings, Rebecca F. Gottesman, Karen Bandeen-Roche, Marilyn Albert, David Knopman, Elizabeth Selvin, Bruce A. Wasserman, Barbara Klein, Ronald Klein
First published February 28, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005205
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Article Information

vol. 90 no. 13 e1158-e1166
DOI: 
https://doi.org/10.1212/WNL.0000000000005205
PubMed: 
29490915
Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received May 3, 2017
  • Accepted in final form December 19, 2017
  • First Published February 28, 2018.

Article Versions

Copyright & Usage: 
© 2018 American Academy of Neurology

Author Disclosures

    1. Jennifer A. Deal, PhD,
    2. A. Richey Sharrett, MD, DrPH,
    3. Andreea M. Rawlings, MS, PhD,
    4. Rebecca F. Gottesman, MD, PhD,
    5. Karen Bandeen-Roche, PhD,
    6. Marilyn Albert, PhD,
    7. David Knopman, MD,
    8. Elizabeth Selvin, PhD, MPH,
    9. Bruce A. Wasserman, MD,
    10. Barbara Klein, MD, MPH and
    11. Ronald Klein, MD, MPH
  1. Jennifer A. Deal, PhD,
    2. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  2. A. Richey Sharrett, MD, DrPH,
    3. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NHLBI HL 96812, Co-Investigator 2010-2014

    Research Support, Academic Entities:

    1. Professor, Johns Hopkins Bloomberg School of Public Health

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  3. Andreea M. Rawlings, MS, PhD,
    4. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  4. Rebecca F. Gottesman, MD, PhD,
    5. Scientific Advisory Boards:

    1. Member of DSMB for "Sail-on" study, (PI: V. Urrutia), funded via Genentech (no compensation received).

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Cardiothoracic Surgery Symposium; funds for travel (reimbursement)

    Editorial Boards:

    1. Neurology, Associate Editor, 2015-present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. Florbetapir isotope (18F-AV-45) provided for investigator-initiated research by Avid Radiopharmaceuticals, a wholly owned subsidiary of Eli Lilly.

    Research Support, Government Entities:

    1. National Institutes of Health/ National Institute on Aging. 1R01AG040282, Principal Investigator, 9/2011-8/2021 RF1 AG050745, Multiple Principal Investigator, 4/2016-3/2021

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  5. Karen Bandeen-Roche, PhD,
    6. Scientific Advisory Boards:

    1. 3 nonprofit advisory boards. Yearly service. Honarium < $1000.00 per case.

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. (1) MedImmune LLC. (2) Geisinger Health Systems.

    Research Support, Government Entities:

    1. (1) P50AG005146 (Albert) 04/01/10 ? 03/31/20 NIH/NIA; Role: Co-Investigator; Data Core Director Johns Hopkins Alzheimer's Disease Research Center (ADRC) The aims are to coordinate and integrate all aspects of data management, provide statistical support and expert statistical consultation for projects, and develop novel methods of analysis for the ADRC. (2) 2P30AG021334 (Walston/Bandeen Roche) 07/01/13 ? 06/30/18 NIH/NIA; Role: Director of the Biostatistics Core Older Americans Independence Center The Center is dedicated to research to determine the causes and treatments for frailty in older adults. (3) UL1TR001079 (Ford) 09/26/13 ? 04/30/18 NIH/NCRR; Role: Co-Investigator; Deputy Director Institutional Clinical and Translational Science Award Goals are to enhance the process and benefits of clinical and translational research by bringing together the diverse resources of the JHMI and creating a new model for carrying out scientific research (4) 1UH2AG056933-01 (Walston) 07/01/17 ? 06/30/22 NIH/NIA; Role: Co-Investigator Characterizing Resiliencies to Physical Stressors in Older Adults: A Dynamical Physiological Systems Approach In phase 1 of this study, data will be generated to characterize age-related changes in physical resiliencies and their determinants and outcomes. In phase 2, measures of resiliency will be constructed, validated and assessed for clinical value, and biologic mechanisms determining specific resiliencies will be investigated. (5) 1R03AG053743-01 (Xue) 09/01/16 ? 05/31/18 NIH/NIA; Role: Co-Investigator Physical Frailty and Cognitive Impairment: Intersection, Measurement & Etiologies The proposal aims to study the natural history of the development of physical frailty and cognitive impairment, and propose and validate a joint phenotype of physical frailty and cognitive impairment. (6) P30AG048773 (Roth) 09/30/14 ? 05/31/19 NIH/NIA; Role: Co-Investigator Roybal Centers for Translational Research on Aging - Strengthening Informal Support Resources with Strategic Methodological Advances Provide leadership and critical infrastructure to stimulate, facilitate, and extend innovative research in the behavioral and social sciences for older adults. Unifying emphases are on understanding and strengthening the informal support resources of vulnerable older adult populations, and methodological innovations. (7) P01AG009973 (Gallagher) 08/15/15-05/31/20 NIH/NIA; Role: Co-Investigator; Data Core Leader Cognition and Hippocampal/Cortical Systems in Aging This multi-component research program studies a rodent model of naturally occurring variation in cognitive aging. It aims to understand the neurobiological basis of impairment and preservation of brain function. (8) 1R01AG050560-01 (Walston) 09/01/16-05/31/18 NIH/NIA; Role: Co-Investigator Enhancing Mobility in Older Adults by Treating Chronic Inflammation: Pilot Phase Few options have been tested for ameliorating mobility declines in older adults through treatment of chronic inflammation (CI). We propose preliminary work needed to develop an inflammatory phenotype that can be utilized in future intervention studies on effects of reducing low-grade CI on mobility limitations in older adults. (9)R03AG048541 (Xue) 07/01/14 ? 06/30/17 NIH/NIA; Role: Co-Investigator Frailty Assessment: Matching Simplification Efforts to Clinical Aims This study contrasts two commonly used assessment tools for identifying frail old adults and evaluates potential ways to simplify the tools for clinical practice. (10) R01 HL096812 (Coresh) 09/01/15 - 06/30/17 NIH/NHLBI; Role: Co-Investigator 1 of 5 Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) aims to elucidate factors underlying ethnic disparities in dementia burden and provide scientific basis for prevention strategies. (11) 113000-0615 (Bandeen-Roche) 09/23/14 ? 05/31/17 KKI sub; Role: Principal Investigator Intellectual and Development Disabilities The Biostatistics Component of our IDDRC?s Clinical Translational Core supports a broad range of projects focused on expanded understanding of developmental disorders. (12)ME-1303-5946 (Bridges) 07/1/13 ? 11/30/16 PCORI: Role: Co-Investigator Advancing stated-preference methods for measuring the preferences of patients with type 2 diabetes This project aims to advance and disseminate methods for patient and stakeholder engagement in patient-centered outcomes research. We address methodological gaps associated with stated-preferences methods.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  6. Marilyn Albert, PhD,
    7. Scientific Advisory Boards:

    1. Eli Lilly

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Center for Vital Longevity, Univ Texas - honorarium

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. Consultant to: Dana Foundation

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. Avid Radiopharmaceuticals - research grant

    Research Support, Government Entities:

    1. Grants from NIH: NIH/NIA, U19-AG033655 (PI) 2009 - present NIH/NIA, P50 AG005146 (PI) 2009 - present NIH/NIA, R01 AG048349 (Co-PI) 2015 - present NIH/NINDS UH2 NS100588(Co-PI) 2016 - present

    Research Support, Academic Entities:

    1. Massachusetts General Hospital, Harvard Medical School

    Research Support, Foundations and Societies:

    1. Alzheimer's Association and Fidelity Biosciences

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  7. David Knopman, MD,
    8. Scientific Advisory Boards:

    1. Consultant Bluefield project (frontotemporal dementia) (ongoing); Lundbeck Pharmaceuticals (Sept 2013 to August 2017); DIAN study DSMB (Sept 2013 ongoing).

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. (1) Lectures, Behavioral Neurology Conference, Hyderabad, India April 2016

    Editorial Boards:

    1. Associate Editor Neurology, ended October 2015

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. (1) Tau Rx clinical trial funded by TAURX (site PI) (2) A4 clinical trial partially funded by Lilly (site PI) (3) Biogen Alzheimer Study (site PI)

    Research Support, Government Entities:

    1. NIH: R01-AG11378 ongoing, P50-AG 16574 (Mayo Alzheimer?s Disease Research Center) ongoing, U01 AG 06786 (Mayo Alzheimer Disease Patient Registry) ongoing. 1U01HL096917-01 ARIC Dementia Study. AG 037551 Chronic Kidney Disease and Cognitive functioning.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  8. Elizabeth Selvin, PhD, MPH,
    9. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Clinical Chemistry

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. FNIH, NKF, NIH/NIDDK grants R01 DK089174, K24 DK106414, R01 HL134320, R01 DK108784

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  9. Bruce A. Wasserman, MD,
    10. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Speaker honoraria: Abington Hospital - Jefferson Health

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. R01AG054491, PI, NIH/NIA

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  10. Barbara Klein, MD, MPH and
    11. Scientific Advisory Boards:

    1. Pfizer Scientific Advisory Committee

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. (1) Ophthalmic Epidemiology, Editorial advisory board, 1994-present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. (1) National Institutes of Health EY006594, HL69979, AG11099, AG021917, AG12100

    Research Support, Academic Entities:

    1. (1) University of Wisconsin-Madison

    Research Support, Foundations and Societies:

    1. (1) Retina Research Foundation

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  11. Ronald Klein, MD, MPH
    12. Scientific Advisory Boards:

    1. Astra-Zeneca 1999-present, advisor

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Ophthalmology Editorial Advisory Board, 1985-present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. Pfizer, consultant, 2007-present Eli Lilly, consultant, 2004-present Novartis, consultant, 2008 Genentech, consultant, 2008 Comentis, data monitoring safety committee member, 2008-2009 Allergan, consultant, 2008 Merck, consultant, 2008

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NIH-NEI, PI, 2 U10 EY006594-21A1 09/01/08 - 06/30/13 NIH-NEI, PI, 1 R01 HL6997 08/15/08 - 8/14/2016 NIH, NEI, PI, 1 R01 EY016379, PI 07/01/05 ? 06/30/09 NIH/DK, PI, 1 R01 DK073217-01 08/20/06 ? 07/31/09 NIH, PI, N01-AG-12100 09/30/02 - 09/29/12

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  1. From the Departments of Epidemiology (J.A.D., A.R.S., A.M.R., R.F.G., E.S.), Neurology (R.F.G., M.A.), Biostatistics (K.B.-R.), and Radiology and Radiological Sciences (B.A.W.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.K.), Mayo Clinic, Rochester, MN; and Department of Ophthalmology and Visual Sciences (B.K., R.K.), University of Wisconsin School of Medicine and Public Health, Madison.
  1. Correspondence
    Dr. Deal jdeal1{at}jhu.edu
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