# Evaluation of retinal imaging as a biomarker of hypertensive effects on cognitive function

> **NIH NIH R21** · OHIO STATE UNIVERSITY · 2024 · $196,094

## Abstract

ABSTRACT
Mild cognitive impairment (MCI) represents a transition state between healthy cognitive aging and dementia.
The estimated prevalence of MCI is 7% for individuals between 60-64 years old and increases to 25% for
those 80-84 years old. There is a need to identify mechanisms that contribute to MCI with the aim of delaying
the onset or preventing Alzheimer’s disease and other dementias. The 2020 Lancet Commission on dementia
prevention, intervention, and care highlighted that midlife hypertension contributes to increased risk for MCI in
late life. Signs of hypertension in the retinal microvessels indicate vascular re-modeling and this re-modeling is
likely happening in the other end organs, such as the brain. There is a gap in knowledge on the relationship
between hypertensive retinopathy and cognitive function decline during aging. The goal of our proposal is to fill
this knowledge gap and advance understanding of the retinal microvessels as a biomarker of hypertensive
effects on cognitive function. We hypothesize that hypertensive retinopathy is associated with lower cognitive
function during aging. We will test this hypothesis with the existing data from the Michigan cohort of the Study
of Women’s Health Across the Nation (SWAN-MI), which is an ongoing 27-year longitudinal study of women
during the transition from midlife to early old age. The longitudinal data relevant for this proposal includes
social determinants of health, cardiovascular parameters, cognitive tests, surveys, and selected blood
chemistries. At the 2016/17 visit, a standardized eye exam and retina imaging that included digital fundus
photographs and optical coherence tomography was performed on 215 women (age 66 ± 2.7 years; 61% black
and 39% white). Using this unique, high-quality SWAN-MI dataset, the objectives of our secondary analyses
include: a) characterizing the relationships between longitudinal cardiovascular data and hypertensive
retinopathy assessed by clinical exam and retina imaging, and b) testing the association between hypertensive
retinopathy and cognitive function during aging. We will test our hypothesis with two aims. Aim 1: Characterize
microvascular features of hypertensive retinopathy and relationships with longitudinal cardiovascular data.
Aim 2: Characterize the relationship between microvascular features in the retina with cognitive function during
aging. Results from our proposed studies will contribute new knowledge about the hypertension-related
mechanisms of dementia, one of public health and social care priorities worldwide with a rapid aging
population. Furthermore, these studies may lead to the formation of integrated health networks that include
teleophthalmology with retinal imaging and eye care providers to improve healthy aging.

## Key facts

- **NIH application ID:** 10754291
- **Project number:** 5R21AG080407-02
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Carrie Anne Karvonen-Gutierrez
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $196,094
- **Award type:** 5
- **Project period:** 2022-12-15 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10754291

## Citation

> US National Institutes of Health, RePORTER application 10754291, Evaluation of retinal imaging as a biomarker of hypertensive effects on cognitive function (5R21AG080407-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10754291. Licensed CC0.

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