Title:Cognitive Performance and Diabetic Retinopathy: What Your Eyes Can
Reveal About Your Brain
Volume: 19
Issue: 9
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*
Affiliation:
- Postgraduate Program in Health Sciences, Pontifical Catholic University of Paraná, (PUCPR), Curitiba, Paraná, Brazil
Keywords:
Diabetic retinopathy, cognitive dysfunction, type 2 diabetes mellitus, risk factors, dementia, cognitive decline.
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.
