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Peer-reviewedCC BYAlzheimer's & dementia : the journal of the Alzheimer's Association

Retinal microvasculature alterations are associated with mild behavioral impairment in Southeast Asian dementia-free older adults.

1 more authors
16 affiliations
  1. 1Memory, Ageing and Cognition Centre, Department of Pharmacology, National University of Singapore, Singapore, Singapore.
  2. 2Department of Psychiatry, School of Public Health, the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
  3. 3Department of Intensive Care Medicine, Department of Anesthesia, Ng Teng Fong General Hospital, National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore.
  4. 4Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
  5. 5St Luke's Hospital, Singapore, Singapore.
  6. 6Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore.
  7. 7Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
  8. 8National University Heart Centre, Singapore, Singapore.
  9. 9Cardiovascular Research Institute, National University of Singapore, Singapore, Singapore.
  10. 10Christchurch Heart Institute, University of Otago Christchurch, Christchurch Hospital, Christchurch, New Zealand.
  11. 11Nanhu Brain-computer Interface Institute, Hangzhou, Zhejiang, China.
  12. 12National Key Laboratory of Brain-Machine Intelligence, Zhejiang University, Hangzhou, Zhejiang, China.
  13. 13Zhejiang Key Laboratory of Intelligent Preventive Medicine, Hangzhou, Zhejiang, China.
  14. 14Centre for Innovation and Precision Eye Health, and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
  15. 15Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
  16. 16Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.

Abstract

Background

Mild behavioral impairment (MBI) is an important neurobehavioral marker of dementia. This study examined associations between retinal vascular measures, MBI, and its potential neurobiological correlates.Methods

Dementia-free older adults from a memory clinic cohort were followed for up to 5 years. MBI was evaluated using the Neuropsychiatric Inventory. Retinal vessel caliber measures were quantified from fundus photographs. Associations of retinal vascular measures with neuroimaging markers of cerebral small vessel disease and plasma proteomic profiles were further explored.Results

Among 302 participants, reduced arteriole-to-venule ratio (AVR) and narrower arteriole caliber (central retinal artery equivalent) were associated with a greater likelihood of incident MBI. Lower AVR was associated with white matter hyperintensity volume and circulating proteins related to immune function and inflammatory processes.Conclusion

Retinal microvascular alterations are associated with MBI in the pre-dementia stage, with exploratory findings suggesting related vascular and inflammatory biological correlates that warrant further investigation.

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BibTeX
@article{liao2026retinal,
  title = {{Retinal microvasculature alterations are associated with mild behavioral impairment in Southeast Asian dementia-free older adults.}},
  author = {Yingqi Liao and Ming Ann Sim and Jiangbo Cui and Haoran Zhang and Saima Hilal and Eddie Jy Chong and Anqi Toh and Boon Yeow Tan and Narayanaswamy Venketasubramanian and Arthur Mark Richards and Xin Xu and Yih Chung Tham and Christopher Chen},
  journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
  year = {2026},
  month = oct,
  doi = {10.1002/alz.71933},
  url = {https://europepmc.org/article/MED/42963327},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Retinal microvasculature alterations are associated with mild behavioral impairment in Southeast Asian dementia-free older adults.
AU  - Yingqi Liao
AU  - Ming Ann Sim
AU  - Jiangbo Cui
AU  - Haoran Zhang
AU  - Saima Hilal
AU  - Eddie Jy Chong
AU  - Anqi Toh
AU  - Boon Yeow Tan
AU  - Narayanaswamy Venketasubramanian
AU  - Arthur Mark Richards
AU  - Xin Xu
AU  - Yih Chung Tham
AU  - Christopher Chen
PY  - 2026
DA  - 2026/10/01
JO  - Alzheimer's & dementia : the journal of the Alzheimer's Association
DO  - 10.1002/alz.71933
UR  - https://europepmc.org/article/MED/42963327
AB  - Background  Mild behavioral impairment (MBI) is an important neurobehavioral marker of dementia. This study examined associations between retinal vascular measures, MBI, and its potential neurobiological correlates.Methods  Dementia-free older adults from a memory clinic cohort were followed for up to 5 years. MBI was evaluated using the Neuropsychiatric Inventory. Retinal vessel caliber measures were quantified from fundus photographs. Associations of retinal vascular measures with neuroimaging markers of cerebral small vessel disease and plasma proteomic profiles were further explored.Results  Among 302 participants, reduced arteriole-to-venule ratio (AVR) and narrower arteriole caliber (central retinal artery equivalent) were associated with a greater likelihood of incident MBI. Lower AVR was associated with white matter hyperintensity volume and circulating proteins related to immune function and inflammatory processes.Conclusion  Retinal microvascular alterations are associated with MBI in the pre-dementia stage, with exploratory findings suggesting related vascular and inflammatory biological correlates that warrant further investigation.
SN  - 1552-5260
SN  - 1552-5279
ER  -