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Diabetic retinopathy and cognitive dysfunction: a systematic review and meta-analysis

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A Letter to the Editor to this article was published on 01 April 2022

Abstract

Background

This study aims to determine the relationship between diabetic retinopathy (DR) and cognitive dysfunction as well as explores the effects of DR on different cognitive domains.

Methods

A systematic search of PubMed, Embase, Web of Science, Wanfang data, CBM, CNKI, and VIP databases from their inception to October 2021. The pooled odds ratio (ORs), hazard ratio (HRs), and 95% confidence interval (CIs) were calculated.

Results

Twenty-two studies met the inclusion criteria and meta-analysis included 15 studies. The presence of DR reflects a higher risk of cognitive dysfunction (OR = 2.45; 95% CI: 1.76–3.41; HR = 1.34 95% CI: 1.10–1.62). Cohort study combined risk was 2.62 (95% CI: 1.93–3.56), in cross-sectional study was 2.07 (95% CI: 1.11–3.88). The pooled OR was 2.38 (95% CI: 1.83–3.10) and 3.11 (95% CI: 1.15–8.40) in Asia and Oceania. No such association was found in North America (OR = 2.22; 95% CI: 0.77–6.38). The pooled risk was 2.47 (95% CI: 1.76–3.48) in patients with T2DM, while did not identify an association between these two conditions in T1DM. The combined unadjusted and adjusted ORs were 2.72 (95% CI: 1.99–3.73) and 2.06 (95% CI: 1.49–2.85). DR severity and the risk of cognitive impairment showed a positive correlation and mainly impaired the speeds of psychomotor and information processing.

Conclusions

DR can help to identify people at high risk of cognitive dysfunction. Further studies are indispensable for exploring the relationship between DR and cognitive impairment in the patients for different age, gender and race, as well as to assess the risk of cognitive impairment in different populations.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Funding

This work was supported by the Natural Science Foundation of China (No. 81873184).

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Author notes

  1. Mei Wu and Fan Mei have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Evidence-Based Medicine Centre, School of Basic Medical Sciences, School of Nursing, Lanzhou University, Lanzhou, 730030, Gansu, China

    Mei Wu, Fan Mei, Kaiyan Hu, Liyuan Feng, Zhe Wang, Qianqian Gao, Fei Chen, Li Zhao & Bin Ma

  2. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China

    Bin Ma

  3. Lanzhou University second hospital, Lanzhou University, Lanzhou, China

    Xiaohui Li

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Contributions

BM, KH, and MW came up with the original design of the research. MW, FM, ZW, and LF completed literature search, screening and data collection. MW, QG, FC, and LZ performed the statistical analysis. The data were analyzed by MW, FM, XL and BM. MW wrote the first draft of the article and all authors participated in the supplement and revision of the research.

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Correspondence to Xiaohui Li or Bin Ma.

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This article belongs to the topical collection Eye Complications of Diabetes, Health Education and Psycho-Social Aspects managed by Giuseppe Querques.

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Wu, M., Mei, F., Hu, K. et al. Diabetic retinopathy and cognitive dysfunction: a systematic review and meta-analysis. Acta Diabetol 59, 443–459 (2022). https://doi.org/10.1007/s00592-021-01829-0

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