The cross-sectional and longitudinal relationship of diabetic retinopathy to cognitive impairment: a systematic review and meta-analysis

To establish a potential relationship between diabetic retinopathy (DR) and different stages of cognitive impairment METHODS: Literature searches were conducted on PubMed and EMBASE, with keywords "diabetic retinopathy" and "cognitive impairment". Inclusion criteria were original...

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Vydáno v:Eye (London) Ročník 37; číslo 2; s. 220 - 227
Hlavní autoři: Chan, Robert N F, Tang, Ziqi, Chan, Victor T T, Chan, Raymond N C, Cheng, Esther T W, Ng, Natalie C Y, Cheung, Carol Y
Médium: Journal Article
Jazyk:angličtina
Vydáno: England Nature Publishing Group 01.02.2023
Témata:
Age
Cognition
Cognitive ability
Confidence intervals
Cross-Sectional Studies
Dementia
Dementia - complications
Dementia disorders
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 2 - complications
Diabetic retinopathy
Diabetic Retinopathy - complications
Glycated Hemoglobin
Hemoglobin
Humans
Longitudinal studies
Meta-analysis
Quality control
Retinopathy
Risk Factors
ISSN:0950-222X, 1476-5454, 1476-5454
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Shrnutí:To establish a potential relationship between diabetic retinopathy (DR) and different stages of cognitive impairment METHODS: Literature searches were conducted on PubMed and EMBASE, with keywords "diabetic retinopathy" and "cognitive impairment". Inclusion criteria were original human studies, and English language. Quality of studies was assessed by the Newcastle-Ottawa Quality Assessment (NOSGEN). The register number of this study on the International Prospective Register of Systematic Reviews (PROSPERO) is CRD42021236747. The main outcome measures were odds ratios (OR) and risk ratios (RR) for cross-sectional and longitudinal studies, respectively. Meta-regression was performed to evaluate the effects of potential moderator variables, including, age, onset age of diabetes mellitus (DM), duration of DM, and HbA1c. Twenty-five studies (17 cross-sectional and 8 longitudinal studies) with a total of 1,963,914 subjects, were included. Among the cross-sectional studies, the pooled ORs of any cognitive impairment, early stage of cognitive impairment and dementia in subjects with DR (95% confidence interval) were 1.48 (1.08-2.02), 1.59 (1.01-2.51), and 1.13 (0.86-1.50), respectively. Among the longitudinal studies, the pooled RRs of any cognitive impairment, early stage of cognitive impairment, and dementia in subjects with DR (95% confidence interval) were 1.35 (1.12-1.65), 1.50 (1.06-2.12), and 1.31 (1.03-1.66), respectively. Meta-regression showed age, onset age of DM, duration of DM, and glycated hemoglobin (HbA1c) were not statistically associated with the outcomes. The presence of DR in DM patients indicates both higher odds of prevalent cognitive impairment and escalated risks of developing cognitive impairment in the future.
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ISSN:0950-222X
1476-5454
1476-5454
DOI:10.1038/s41433-022-02033-2