Cognitive Function and Its Relationship with Macular Pigment Optical Density and Serum Concentrations of its Constituent Carotenoids

J Alzheimers Dis. 2015;48(1):261-77. doi: 10.3233/JAD-150199.


Background: Macular pigment (MP) levels correlate with brain concentrations of lutein (L) and zeaxanthin (Z), and have also been shown to correlate with cognitive performance in the young and elderly.

Objective: To investigate the relationship between MP, serum concentrations of L and Z, and cognitive function in subjects free of retinal disease with low MP (Group 1, n = 105) and in subjects with AMD (Group 2, n = 121).

Methods: MP was measured using customized heterochromatic flicker photometry and dual-wavelength autofluorescence; cognitive function was assessed using a battery of validated cognition tests; serum L and Z concentrations were determined by HPLC.

Results: Significant correlations were evident between MP and various measures of cognitive function in both groups (r = -0.273 to 0.261, p≤0.05, for all). Both serum L and Z concentrations correlated significantly (r = 0.187, p≤0.05 and r = 0.197, p≤0.05, respectively) with semantic (animal) fluency cognitive scores in Group 2 (the AMD study group), while serum L concentrations also correlated significantly with Verbal Recognition Memory learning slope scores in the AMD study group (r = 0.200, p = 0.031). Most of the correlations with MP, but not serum L or Z, remained significant after controlling for age, gender, diet, and education level.

Conclusion: MP offers potential as a non-invasive clinical biomarker of cognitive health, and appears more successful in this role than serum concentrations of L or Z.

Keywords: Age-related macular degeneration; biomarker; cognitive function; lutein; macular pigment; zeaxanthin.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carotenoids / blood*
  • Chromatography, High Pressure Liquid
  • Cognition Disorders / blood*
  • Cognition Disorders / etiology*
  • Double-Blind Method
  • Female
  • Humans
  • Lutein / blood
  • Macular Degeneration / blood*
  • Macular Degeneration / complications*
  • Macular Degeneration / therapy
  • Macular Pigment / metabolism*
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Photometry
  • Tomography, Optical Coherence
  • Zeaxanthins / blood


  • Macular Pigment
  • Zeaxanthins
  • Carotenoids
  • Lutein