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Association between age-related macular degeneration and subjective cognitive complaints
  1. Zhuoting Zhu1,
  2. Huan Liao2,
  3. Wei Wang1,
  4. Jane Scheetz3,
  5. Jian Zhang1,
  6. Mingguang He1
  1. 1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  2. 2Neural Regeneration Group, Institute of Reconstructive Neurobiology, University of Bonn, Bonn, Germany
  3. 3Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
  1. Correspondence to Dr Mingguang He, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China; mingguanghe{at}


Purpose To investigate the association between age-related macular degeneration (AMD) and subjective cognitive complaints (SCCs) in the USA.

Methods A total of 5604 participants aged 40 years and older from the 2005–2008 National Health and Nutrition Examination Survey were included. Retinal photography was graded into no AMD, early and late AMD based on the modification of the Wisconsin Age-Related Maculopathy Grading System. SCCs were based on the self-reported difficulty in remembering or confusion. Sample weights were used to generate nationally representative data. Multivariate regression analyses were used to assess the association between AMD severity and SCCs, controlling for potential confounders.

Results Participants with any AMD had higher prevalence of SCCs relative to participants without AMD (6.8% vs 13.6%, p<0.001). After adjusting for potential confounding factors, presence of any AMD was significantly associated with 1.62-fold higher odds of having SCCs (95% CI 1.16 to 2.27, p=0.007). Similarly, participants with early (OR 1.58; 95% CI 1.14 to 2.17, p=0.007) and late AMD (OR 2.02; 95% CI 1.08 to 3.79, p=0.030) were also associated with elevated odds of reporting SCCs after controlling for confounders.

Conclusions We found significant associations between AMD severity and SCCs in this US population. More attention should be paid on the subjective memory function and potential risk of cognitive decline among patients with AMD.

  • epidemiology

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  • ZZ, HL and WW contributed equally.

  • Contributors ZZ and WW had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: ZZ, HL, MH. Acquisition, analysis or interpretation: All authors. Drafting of the manuscript: ZZ, HL, WW. Critical revision of the manuscript for important intellectual content: WW, JS, MH. Statistical analysis: ZZ, HL, WW, JZ. Obtained funding: MH. Administrative, technical or material support: ZZ, HL, WW, JZ. Study supervision: WW, JZ, MH.

  • Funding The present work was supported by Fundamental Research Funds of the State Key Laboratory in Ophthalmology. MH receives support from the University of Melbourne at Research Accelerator Program and the Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian state government.

  • Disclaimer The sponsor or funding organisation had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The National Center for Health Statistics Research Ethics Review Board approved the NHANES protocols, and every participant provided written informed consent.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.