Association Between Diabetic Retinopathy and Cognitive Impairment: A Systematic Review and Meta-Analysis

Abstract

Diabetic retinopathy (DR) is one of the most common microvascular complications associated with diabetes mellitus. However, its correlation with another diabetes-related disorder, cognitive impairment, has not been well studied. This systematic review and meta-analysis aimed to explore the association between DR and cognitive impairment. MEDLINE (PubMed), the Cochrane Library, and EMBASE databases were searched for observational studies that reported an association between DR and cognitive impairment. Data from selected studies were extracted, and a meta-analysis was conducted using fixed-effects modeling. Fifteen observational studies were included in the systematic review, and 10 studies were included in the meta-analysis. The odds ratio of the association between DR and cognitive impairment was 2.24 (95% confidence interval [CI], 1.89–2.66; I2 = 0.8%). The hazard ratio of the association between DR and cognitive impairment was significant in four studies, ranging from 1.09–1.32. Minimal or mild DR was not significantly associated with cognitive impairment (odds ratio [OR], 2.04; 95% CI, 0.87–4.77). However, the association between proliferative DR and cognitive impairment (OR, 3.57; 95% CI, 1.79–7.12; I2 = 16.6%) was not stronger than the association between moderate or worse DR and cognitive impairment (OR, 4.26; 95% CI, 2.01–9.07; I2 = 0.0%). DR is associated with cognitive impairment, and screening for DR will be helpful for the early identification of individuals with cognitive impairment. Further studies are needed to confirm the association between proliferative DR and cognitive impairment.

Age-Related Eye Diseases in Individuals With Mild Cognitive Impairment and Alzheimer's Disease

“…To this end, they found that patients with DR had increased prevalence (Ong et al, 2012 ; Liao et al, 2017 ) and incidence (Gupta et al, 2019 ) of CIND, as well as increased incidence of AD (Chen et al, 2016 ; Lee et al, 2019 ; Pedersen et al, 2022 ). A recent systematic review and meta-analysis support these results by concluding that having moderate DR or worse was strongly associated with cognitive impairment (Cheng et al, 2021 ). Considered in tandem with the findings of our study, this suggests that the association between DR and cognitive impairment may be bidirectional.…”

“…Overall, past studies focused overwhelmingly on western populations, reflecting a paucity of data on other races/ethnicities. While several studies have examined the impact of having DR on cognitive impairment (Cheng et al, 2021 ), no studies have examined the impact of having cognitive impairment on DR. Finally, very limited data are available on the impact of CIND on eye diseases, a condition with established risk of progression to AD and other forms of dementia (Petersen, 2016 ).…”

Evaluation of blood interleukin levels and their correlations in the patients with diabetic retinopathy with mild and moderate cognitive impairment

“…Изучение взаимосвязей между выраженностью иммунологических изменений и когнитивными нарушениями у пациентов с диабетической ретинопатией представляет одну из актуальных проблем современной иммунологии [5,6]. Несколько исследований анализировали связь диабетической ретинопатии с когнитивными нарушениями, показав противоречивые результаты [3]. Так, в недавнем метаанализе [3], включившим в себя 15 исследований из базы данных MEDLINE, отношение шансов ассоциации диабетической ретинопатии с когнитивными нарушениями составило 2,24 при 95% доверительном интервале 1,89-2,66.…”

“…Несколько исследований анализировали связь диабетической ретинопатии с когнитивными нарушениями, показав противоречивые результаты [3]. Так, в недавнем метаанализе [3], включившим в себя 15 исследований из базы данных MEDLINE, отношение шансов ассоциации диабетической ретинопатии с когнитивными нарушениями составило 2,24 при 95% доверительном интервале 1,89-2,66. Однако в исследовании [9], выполненном на большой группе пациентов с диабетической ретинопатией, не обнаружено связи между диабетической ретинопатией и ухудшением когнитивных функций.…”

Interleukins in lacrimal fluid and diabetic retinopathy

“…Неоспоримо ведущая роль диабетической ретинопатии (ДР) как причина слепоты у лиц трудоспособного и пожилого возраста наблюдается в настоящее время во многих развитых странах [2,5,7]. ДР -это наиболее распространенное микрососудистое осложнение сахарного диабета, встречающееся приблизительно у 29% взрослых с диабетом 2-го типа и 95% людей с диабетом 1-го типа [6].…”