Skip to main content
Erschienen in: International Ophthalmology 1/2024

01.12.2024 | Original Paper

The association between the severity of diabetic retinopathy and cognitive impairment: a cross-sectional study

verfasst von: Maryam Dourandeesh, Mitra Akbari, Ali Pourramzani, Yousef Alizadeh, Ehsan Kazemnezhad Leili, Amir Hossein Shemshadi, Ghazaleh Mohammadi-manesh

Erschienen in: International Ophthalmology | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To assess the correlation among cognitive impairment (CI) and the degree of diabetic retinopathy (DR).

Methods

The current analytic cross-sectional study has been carried out on two hundred ten individuals having diabetes mellitus type 2. Individuals were split into 7 groups in order of severity of DR in the worse eye with 30 cases in each group. Cognition function has been determined utilizing mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) tests.

Results

Comparing the severity of CI using both MMSE and MoCA tests, statistically substantial differences have been discovered among individuals without DR, those having non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) (p < 0.001). The greatest percentage of severe and moderate CI was seen in the PDR group. Regarding the severity of CI, there has been a statistically substantial difference among NPDR and PDR groups, as well as among no-DR and PDR groups (p < 0.001). Moreover, the severity of CI in the MMSE and MoCA tests had a negative connection with the grades of DR (r = − 0.522, P < 0.001 and r = − 0.540, P < 0.001, respectively).

Conclusion

We discovered a negative connection between the grades of DR and the severity of CI that persisted as a significant finding, showing that patients with more severe DR tended to have higher levels of CI. These results might offer retinal examination or retinal photography as a promising strategy for mass screening of CI in diabetic patients, especially if it is combined with artificial intelligence and telemedicine.
Literatur
4.
Zurück zum Zitat Ruta L, Magliano D, Lemesurier R, Taylor H, Zimmet P, Shaw J (2013) Prevalence of diabetic retinopathy in Type 2 diabetes in developing and developed countries. Diabet Med 30(4):387–398CrossRefPubMed Ruta L, Magliano D, Lemesurier R, Taylor H, Zimmet P, Shaw J (2013) Prevalence of diabetic retinopathy in Type 2 diabetes in developing and developed countries. Diabet Med 30(4):387–398CrossRefPubMed
6.
Zurück zum Zitat Gupta P, Gan ATL, Man REK et al (2019) Association between diabetic retinopathy and incident cognitive impairment. Br J Ophthalmol 103(11):1605–1609CrossRefPubMed Gupta P, Gan ATL, Man REK et al (2019) Association between diabetic retinopathy and incident cognitive impairment. Br J Ophthalmol 103(11):1605–1609CrossRefPubMed
7.
Zurück zum Zitat Amidei CB, Fayosse A, Dumurgier J et al (2021) Association between age at diabetes onset and subsequent risk of dementia. JAMA 325(16):1640–1649CrossRef Amidei CB, Fayosse A, Dumurgier J et al (2021) Association between age at diabetes onset and subsequent risk of dementia. JAMA 325(16):1640–1649CrossRef
8.
Zurück zum Zitat Chan RN, Tang Z, Chan VT et al (2022) The cross-sectional and longitudinal relationship of diabetic retinopathy to cognitive impairment: a systematic review and meta-analysis. Eye 2022:1–8 Chan RN, Tang Z, Chan VT et al (2022) The cross-sectional and longitudinal relationship of diabetic retinopathy to cognitive impairment: a systematic review and meta-analysis. Eye 2022:1–8
9.
Zurück zum Zitat van Sloten TT, Sedaghat S, Carnethon MR, Launer LJ, Stehouwer CD (2020) Cerebral microvascular complications of type 2 diabetes: stroke, cognitive dysfunction, and depression. Lancet Diabetes Endocrinol 8(4):325–336CrossRefPubMed van Sloten TT, Sedaghat S, Carnethon MR, Launer LJ, Stehouwer CD (2020) Cerebral microvascular complications of type 2 diabetes: stroke, cognitive dysfunction, and depression. Lancet Diabetes Endocrinol 8(4):325–336CrossRefPubMed
10.
Zurück zum Zitat Cheng D, Zhao X, Yang S, Wang G, Ning G (2021) Association between diabetic retinopathy and cognitive impairment: a systematic review and meta-analysis. Front Aging Neurosci 13:366CrossRef Cheng D, Zhao X, Yang S, Wang G, Ning G (2021) Association between diabetic retinopathy and cognitive impairment: a systematic review and meta-analysis. Front Aging Neurosci 13:366CrossRef
11.
Zurück zum Zitat Lu X, Gong W, Wen Z, Hu L, Peng Z, Zha Y (2019) Correlation between diabetic cognitive impairment and diabetic retinopathy in patients with T2DM by 1H-MRS. Front Neurol 10:1068CrossRefPubMedPubMedCentral Lu X, Gong W, Wen Z, Hu L, Peng Z, Zha Y (2019) Correlation between diabetic cognitive impairment and diabetic retinopathy in patients with T2DM by 1H-MRS. Front Neurol 10:1068CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Oğurel T, Oğurel R, Özer M, Türkel Y, Dağ E, Örnek K (2015) Mini-mental state exam versus montreal cognitive assessment in patients with diabetic retinopathy. Niger J Clin Pract 18(6):786–789CrossRefPubMed Oğurel T, Oğurel R, Özer M, Türkel Y, Dağ E, Örnek K (2015) Mini-mental state exam versus montreal cognitive assessment in patients with diabetic retinopathy. Niger J Clin Pract 18(6):786–789CrossRefPubMed
13.
Zurück zum Zitat Crosby-Nwaobi RR, Sivaprasad S, Amiel S, Forbes A (2013) The relationship between diabetic retinopathy and cognitive impairment. Diabetes Care 36(10):3177–3186CrossRefPubMedPubMedCentral Crosby-Nwaobi RR, Sivaprasad S, Amiel S, Forbes A (2013) The relationship between diabetic retinopathy and cognitive impairment. Diabetes Care 36(10):3177–3186CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Deal JA, Sharrett AR, Albert M et al (2019) Retinal signs and risk of incident dementia in the atherosclerosis risk in communities study. Alzheimers Dement 15(3):477–486CrossRefPubMed Deal JA, Sharrett AR, Albert M et al (2019) Retinal signs and risk of incident dementia in the atherosclerosis risk in communities study. Alzheimers Dement 15(3):477–486CrossRefPubMed
17.
Zurück zum Zitat Yang Z, Tan T-E, Shao Y, Wong TY, Li X (2022) Classification of diabetic retinopathy: past, present and future. Front Endocrinol 13:1079217CrossRef Yang Z, Tan T-E, Shao Y, Wong TY, Li X (2022) Classification of diabetic retinopathy: past, present and future. Front Endocrinol 13:1079217CrossRef
18.
Zurück zum Zitat Hansen MB, Abramoff MD, Folk JC, Mathenge W, Bastawrous A, Peto T (2015) Results of automated retinal image analysis for detection of diabetic retinopathy from the Nakuru study Kenya. PLoS ONE 10(10):e0139148CrossRefPubMedPubMedCentral Hansen MB, Abramoff MD, Folk JC, Mathenge W, Bastawrous A, Peto T (2015) Results of automated retinal image analysis for detection of diabetic retinopathy from the Nakuru study Kenya. PLoS ONE 10(10):e0139148CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Ong SY, Cheung CY, Li X et al (2012) Visual impairment, age-related eye diseases, and cognitive function: the Singapore Malay eye study. Arch Ophthalmol 130(7):895–900CrossRefPubMed Ong SY, Cheung CY, Li X et al (2012) Visual impairment, age-related eye diseases, and cognitive function: the Singapore Malay eye study. Arch Ophthalmol 130(7):895–900CrossRefPubMed
20.
Zurück zum Zitat Ding J, Strachan MW, Reynolds RM et al (2010) Diabetic retinopathy and cognitive decline in older people with type 2 diabetes: the Edinburgh type 2 diabetes study. Diabetes 59(11):2883–2889CrossRefPubMedPubMedCentral Ding J, Strachan MW, Reynolds RM et al (2010) Diabetic retinopathy and cognitive decline in older people with type 2 diabetes: the Edinburgh type 2 diabetes study. Diabetes 59(11):2883–2889CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Hugenschmidt CE, Lovato JF, Ambrosius WT et al (2014) The cross-sectional and longitudinal associations of diabetic retinopathy with cognitive function and brain MRI findings: the action to control cardiovascular risk in diabetes (ACCORD) trial. Diabetes Care 37(12):3244–3252CrossRefPubMedPubMedCentral Hugenschmidt CE, Lovato JF, Ambrosius WT et al (2014) The cross-sectional and longitudinal associations of diabetic retinopathy with cognitive function and brain MRI findings: the action to control cardiovascular risk in diabetes (ACCORD) trial. Diabetes Care 37(12):3244–3252CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Kawamura T, Umemura T, Hotta N (2015) Curious relationship between cognitive impairment and diabetic retinopathy. J Diabetes Investig 6(1):21CrossRefPubMed Kawamura T, Umemura T, Hotta N (2015) Curious relationship between cognitive impairment and diabetic retinopathy. J Diabetes Investig 6(1):21CrossRefPubMed
23.
Zurück zum Zitat Biessels GJ, Strachan MW, Visseren FL, Kappelle LJ, Whitmer RA (2014) Dementia and cognitive decline in type 2 diabetes and prediabetic stages: towards targeted interventions. Lancet Diabetes Endocrinol 2(3):246–255CrossRefPubMed Biessels GJ, Strachan MW, Visseren FL, Kappelle LJ, Whitmer RA (2014) Dementia and cognitive decline in type 2 diabetes and prediabetic stages: towards targeted interventions. Lancet Diabetes Endocrinol 2(3):246–255CrossRefPubMed
24.
Zurück zum Zitat Sinha S, Ekka M, Sharma U, Pandey R, Jagannathan N (2014) Assessment of changes in brain metabolites in Indian patients with type-2 diabetes mellitus using proton magnetic resonance spectroscopy. BMC Res Notes 7(1):1–7CrossRef Sinha S, Ekka M, Sharma U, Pandey R, Jagannathan N (2014) Assessment of changes in brain metabolites in Indian patients with type-2 diabetes mellitus using proton magnetic resonance spectroscopy. BMC Res Notes 7(1):1–7CrossRef
25.
Zurück zum Zitat Kisler K, Nelson AR, Montagne A, Zlokovic BV (2017) Cerebral blood flow regulation and neurovascular dysfunction in Alzheimer disease. Nat Rev Neurosci 18(7):419–434CrossRefPubMedPubMedCentral Kisler K, Nelson AR, Montagne A, Zlokovic BV (2017) Cerebral blood flow regulation and neurovascular dysfunction in Alzheimer disease. Nat Rev Neurosci 18(7):419–434CrossRefPubMedPubMedCentral
27.
28.
Zurück zum Zitat Garhöfer G, Chua J, Tan B, Wong D, Schmidl D, Schmetterer L (2020) Retinal neurovascular coupling in diabetes. J Clin Med 9(9):2829CrossRefPubMed Garhöfer G, Chua J, Tan B, Wong D, Schmidl D, Schmetterer L (2020) Retinal neurovascular coupling in diabetes. J Clin Med 9(9):2829CrossRefPubMed
29.
Zurück zum Zitat Patton N, Aslam T, MacGillivray T, Pattie A, Deary IJ, Dhillon B (2005) Retinal vascular image analysis as a potential screening tool for cerebrovascular disease: a rationale based on homology between cerebral and retinal microvasculatures. J Anat 206(4):319–348CrossRefPubMedPubMedCentral Patton N, Aslam T, MacGillivray T, Pattie A, Deary IJ, Dhillon B (2005) Retinal vascular image analysis as a potential screening tool for cerebrovascular disease: a rationale based on homology between cerebral and retinal microvasculatures. J Anat 206(4):319–348CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Cordell CB, Borson S, Boustani M et al (2013) Alzheimer’s Association recommendations for operationalizing the detection of cognitive impairment during the medicare annual wellness visit in a primary care setting. Alzheimers Dement 9(2):141–150CrossRefPubMed Cordell CB, Borson S, Boustani M et al (2013) Alzheimer’s Association recommendations for operationalizing the detection of cognitive impairment during the medicare annual wellness visit in a primary care setting. Alzheimers Dement 9(2):141–150CrossRefPubMed
31.
Zurück zum Zitat Ozer S, Young J, Champ C, Burke M (2016) A systematic review of the diagnostic test accuracy of brief cognitive tests to detect amnestic mild cognitive impairment. Int J Geriatr Psychiatry 31(11):1139–1150CrossRefPubMed Ozer S, Young J, Champ C, Burke M (2016) A systematic review of the diagnostic test accuracy of brief cognitive tests to detect amnestic mild cognitive impairment. Int J Geriatr Psychiatry 31(11):1139–1150CrossRefPubMed
Metadaten
Titel
The association between the severity of diabetic retinopathy and cognitive impairment: a cross-sectional study
verfasst von
Maryam Dourandeesh
Mitra Akbari
Ali Pourramzani
Yousef Alizadeh
Ehsan Kazemnezhad Leili
Amir Hossein Shemshadi
Ghazaleh Mohammadi-manesh
Publikationsdatum
01.12.2024
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 1/2024
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-024-03022-y

Weitere Artikel der Ausgabe 1/2024

International Ophthalmology 1/2024 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Metastase in der periokulären Region

Metastasen Leitthema

Orbitale und periokuläre metastatische Tumoren galten früher als sehr selten. Aber mit der ständigen Aktualisierung von Medikamenten und Nachweismethoden für die Krebsbehandlung werden neue Chemotherapien und Strahlenbehandlungen eingesetzt. Die …

Staging und Systemtherapie bei okulären und periokulären Metastasen

Metastasen Leitthema

Metastasen bösartiger Erkrankungen sind die häufigsten Tumoren, die im Auge diagnostiziert werden. Sie treten bei ungefähr 5–10 % der Patienten mit soliden Tumoren im Verlauf der Erkrankung auf. Besonders häufig sind diese beim Mammakarzinom und …

Wundheilung nach Trabekulektomie

Trabekulektomie CME-Artikel

Die überschießende Wundheilung in der filtrierenden Glaukomchirurgie ist ein zentraler Faktor für ein operatives Versagen. Nach der Einführung der Trabekulektomie in den 1960er-Jahren wurden viele Faktoren erkannt, die mit einer vermehrten …

„standard operating procedures“ (SOP) – Vorschlag zum therapeutischen Management bei periokulären sowie intraokulären Metastasen

Metastasen Leitthema

Peri- sowie intraokuläre Metastasen sind insgesamt gesehen selten und meist Zeichen einer fortgeschrittenen primären Tumorerkrankung. Die Therapie ist daher zumeist palliativ und selten kurativ. Zudem ist die Therapiefindung sehr individuell. Die …

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.