Diabetic retinopathy (DR) and cognitive dysfunction are both common complications of type 2 diabetes mellitus (T2DM), although the relationship between them remains incompletely understood. A systematic review and meta-analysis published in Journal of Diabetes Research evaluated associations between DR and cognitive dysfunction in adults with T2DM.
The analysis included 48 observational studies identified through searches of PubMed, Embase, Web of Science, and Chinese databases from 2000 through March 2025. Random-effects models were used to evaluate associations across cross-sectional and cohort studies.
Findings
- Cross-sectional studies showed a strong association between DR and cognitive dysfunction (odds ratio [OR] 2.04; 95% CI 1.72–2.42; I² = 0.0%).
- Cohort studies showed a more modest but significant association (OR 1.13; 95% CI 1.01–1.26; I² = 85.2%).
- The strongest associations were observed for mild cognitive impairment (cross-sectional OR 2.15) and dementia (cross-sectional OR 2.20; cohort OR 1.17).
- Longer diabetes duration (≥10 years) strengthened associations in cross-sectional studies (OR 2.05).
- Extended follow-up (≥10 years) was associated with stronger associations in cohort studies (OR 1.91).
DR was associated with higher odds of cognitive dysfunction in adults with T2DM, particularly mild cognitive impairment and dementia. Further prospective studies are needed to clarify the clinical utility of DR as a marker of cognitive dysfunction risk.
