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Current Diabetes Reviews

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ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

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Research Article

Cognitive Performance and Diabetic Retinopathy: What Your Eyes Can Reveal About Your Brain

Author(s): Ana Cristina Ravazzani de Almeida Faria, Joceline Franco Dall'Agnol, Aline Maciel Gouveia, Clara Inácio De Paiva, Victoria Chechetto Segalla, Fernando Eiji Ogata and Cristina Pellegrino Baena*

Volume 19, Issue 9, 2023

Published on: 18 October, 2022

Article ID: e050822207323 Pages: 9

DOI: 10.2174/1573399819666220805154638

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Abstract

Background: Diabetic retinopathy (DR) is a chronic diabetes complication. People with Type 2 Diabetes Mellitus (T2DM) have two times the risk for dementia, suggesting it is a new chronic diabetes complication.

Objective: Evaluate the association of DR with cognitive performance in a T2DM population.

Methods: Cross-sectional study with 400 T2DM adults from whom socio-demographic, clinical, laboratory data were collected, and screening test for depression symptoms (Patient Health Questionaire- 9 (PHQ-9)), Mini-Mental State Examination (MMSE), Semantic Verbal Fluency Test, Trail Making Test A and B, Word Memory test were performed. All cognitive test scores were converted into Global Cognition z-Score (GCS(z)). The association between GCS(z) < 0 with DR was performed using a multivariate binary logistic regression model adjusted for age ≥ 65 years, school years ≤ 6 years, DM duration ≥ 10 years, depression symptoms score > 9 at PHQ-9, arterial hypertension, physical activity, diabetic retinopathy, macular edema, and cardiovascular disease.

Results: After exclusions, the 251 eligible patients were 56.6% female, with a mean age of 61.1 (±9.8) years, DM duration of 12.6 (±8.9) years, and 7.6 (±4.2) years of school education. DR prevalence was 46.5%. Multivariate Logistic Regression Model showed an association between DR and GCS(z) < 0, with odds ratio (CI95%) of 2.50 (1.18-5.34), adjusted for age, low education level, arterial hypertension and depression symptoms (OD and CI95% respectively: 5.46(2.42-12.34); 12.19 (5.62-26.46); 2.55 (0.88-7.39); 3.53 (1.55-8.07)).

Conclusion: In this T2DM population, having DR increased the chance for worse cognitive performance even when adjusted for age, low education level, presence of arterial hypertension, and depression symptoms.

Keywords: Diabetic retinopathy, cognitive dysfunction, type 2 diabetes mellitus, risk factors, dementia, cognitive decline.

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