Association of retinal vascular fractal dimension with cognitive impairment among community‐dwelling older adults in Taiwan
Bibliographic record
Abstract
Abstract Background The eye's vascular system, sharing developmental origins and high metabolic demands with the brain, is an essential early predictor of cognitive impairment. This study investigates the association between retinal vascular fractal dimension (D f ) and cognitive function, addressing gaps in longitudinal research with a comprehensive domain‐specific assessment in community‐dwelling older adults. Method Data (2015‐2024) were drawn from the Taiwan Initiative for Geriatric Epidemiological Research (TIGER), an ongoing prospective cohort study initiated in 2011. Between 2015 and 2017 (baseline of this study), 276 older adults aged 65 or older were included after applying exclusion criteria in this study. Retinal images were captured using a Canon CR‐2 AF fundus camera. Retinal vascular complexity was quantified using the box‐counting method to calculate D f , with lower D f values indicating reduced branching complexity. Global cognition was assessed biennially with four repeats using the Montreal Cognitive Assessment‐Taiwanese version and across four domains (memory, attention, verbal fluency, and executive function) using a battery of neuropsychological tests. Generalized linear mixed models examined associations between tertile‐categorized D f and cognition, adjusting for age, sex, years of education, apolipoprotein E (APOE) ε4 status, depressive symptoms, and other covariates. Result The mean age of participants was 75.3 years old with 56.2% of women. The distributions of hyperlipidemia, age, and short physical performance battery (SPPB) scores significantly differed between two groups (low vs. medium+high) of the retinal vascular dimension of the right eye ( p ‐value=0.003‐0.04). In contrast, significant differences were found in hypertension, age, SPPB scores, and C‐reactive protein (CRP) for the left eye ( p ‐value=<.0001‐0.04). A significant association was found between right eye D f (low vs. medium+high) and performance in the attention domain (β=0.28), which was particularly evident in women, younger individuals, and those with higher education levels. No significant associations were found in other cognitive domains or while treating D f as a continuous variable. Conclusion Over time, we found that higher retinal vascular D f was associated with better attention performance in the community‐dwelling elders in the TIGER cohort, especially for the right eye. Further research is required to validate these findings and clarify the mechanisms linking eye vascular complexity differences to cognitive impairment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".