{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:09:16Z","timestamp":1789560556383,"version":"build-2803163510"},"reference-count":62,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>The retinal nerve fiber layer (RNFL) or ganglion cell\u2013inner plexiform layer (GC\u2010IPL) is associated with cognitive impairment. However, the relationship between retinal asymmetry and cognitive frailty (CF) remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Two hundred twenty\u2010two community\u2010dwelling older adults were assessed starting in 2015 and underwent biennial cognitive and frailty evaluations until 2022. Retinal asymmetry was defined as the absolute interocular retinal difference. Generalized linear mixed models estimated the risk of CF over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Among the participants, 158 completed the 4\u2010year follow\u2010up. Greater baseline GC\u2010IPL asymmetry was associated with worsening CF over time (adjusted odds ratio\u00a0=\u00a01.06; 95% confidence interval [CI]\u00a0=\u00a01.03, 1.10), with handgrip strength asymmetry significantly modifying this association (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction\u00a0<\/jats:sub>\n                      =\u00a00.02). GC\u2010IPL asymmetry was associated with cognitive impairment ( =\u00a0\u22121.69\u00a0\u00d7\u00a010\n                      <jats:sup>\u22122<\/jats:sup>\n                      ; 95% CI\u00a0=\u00a0\u22123.13\u00a0\u00d7\u00a010\n                      <jats:sup>\u22122<\/jats:sup>\n                      , \u22120.25\u00a0\u00d7\u00a010\n                      <jats:sup>\u22122<\/jats:sup>\n                      ) but not with physical frailty. RNFL showed no significant association with CF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Interocular GC\u2010IPL asymmetry might be a new biomarker for CF in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Interocular ganglion cell\u2013inner plexiform layer (GC\u2010IPL) asymmetry was associated with impaired memory\u2013frailty, with handgrip strength asymmetry significantly modifying this association.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Interocular GC\u2010IPL asymmetry was associated with cognitive impairment.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Interocular retinal asymmetry might be a structural biomarker of cognitive frailty.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.14437","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T05:49:13Z","timestamp":1734932953000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Interocular retinal asymmetry and cognitive frailty: A prospective cohort study"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3103-5807","authenticated-orcid":false,"given":"Yung\u2010Sung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Chang Gung 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