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

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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.

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Acknowledgements

The authors of the present study sincerely thank Mrs. Shila Kianmehr for her expert work on this project at the Research Center.

Funding

The authors declare that no funds, grants, or other support was received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Eye, Eye Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Science, Rasht, Iran

    Maryam Dourandeesh, Mitra Akbari, Yousef Alizadeh, Ehsan Kazemnezhad Leili, Amir Hossein Shemshadi & Ghazaleh Mohammadi-manesh

  2. Department of Psychiatry, Kavosh Cognitive Behavior Sciences and Addiction Research Center, School of Medicine, Guilan University of Medical Science, Rasht, Iran

    Ali Pourramzani

Authors
  1. Maryam Dourandeesh
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  2. Mitra Akbari
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  3. Ali Pourramzani
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  4. Yousef Alizadeh
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  5. Ehsan Kazemnezhad Leili
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  6. Amir Hossein Shemshadi
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  7. Ghazaleh Mohammadi-manesh
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [MD], [MA] and [EKL]. The first draft of the manuscript was written by [MD and MA], and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mitra Akbari.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

Vice-Chancellor of Research and Technology of Guilan University of Medical Sciences, Rasht, Iran, approved this project with a permission of the ethics committee with the code IR.GUMS.REC.1401.308.

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Informed consent was obtained from all individual participants included in the study.

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Dourandeesh, M., Akbari, M., Pourramzani, A. et al. The association between the severity of diabetic retinopathy and cognitive impairment: a cross-sectional study. Int Ophthalmol 44, 30 (2024). https://doi.org/10.1007/s10792-024-03022-y

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