Diabetic retinopathy and dementia association, beyond diabetes severity
Open accessAbstract
Purpose To investigate whether associations between diabetic retinopathy (DR) and dementia and Alzheimer's disease (AD) remain significant after controlling for several measures of diabetes severity.Design Retrospective cohort study.Methods Adult Changes in Thought (ACT) is a prospective cohort study of adults aged ≥65 years, randomly selected and recruited from the membership rolls of Kaiser Permanente Washington, who are dementia free at enrollment and followed biennially until incident dementia. The ACT participants were included in this study if they had type 2 diabetes mellitus at enrollment or developed it during follow-up, and data were collected through September, 2018 (3516 person-years of follow-up). Diabetes was defined by ≥ 2 diabetes medication fills in 1 year. Diagnosis of DR was based on International Classification of Diseases Ninth and Tenth Revision codes. Estimates of microalbuminuria, long-term glycemia, and renal function from longitudinal laboratory records were used as indicators of diabetes severity. Alzheimer's disease and dementia were diagnosed using research criteria at expert consensus meetings.Results A total of 536 participants (median baseline age 75 [interquartile range 71-80], 54% women) met inclusion criteria. Significant associations between DR >5 years duration with dementia (hazard ratio 1.81 [95% CI 1.23, 2.65]) and AD (1.80 [1.15, 2.82]) were not altered by adjustment for estimates of microalbuminuria, long-term glycemia, and renal function (dementia: 1.69 [1.14, 2.50]; AD: 1.73 [1.10, 2.74]).Conclusions Among people with type 2 diabetes, DR itself appears to be an important biomarker of dementia risk in addition to glycemia and renal complications.
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In a study of diabetic retinopathy and dementia, the association between retinopathy and dementia remained after adjusting for diabetes severity, as measured by five years of glucose levels control and renal function after >5 years of diabetic retinopathy.
“A study of diabetic retinopathy and dementia found that the association between retinopathy and dementia remained after adjusting for diabetes severity, as measured by five years of glucose levels control and renal function after >5 years of diabetic retinopathy. (258)”
From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [258]
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- Authors
- Lee, C. S., Krakauer, C., Su, Y.-R., Walker, R. L., Blazes, M., McCurry, S. M., Bowen, J. D., McCormick, W. C., Lee, A. Y., Boyko, E. J., O'Hare, A. M., Larson, E. B., & Crane, P. K.
- Affiliations
- University of Washington (US)
- Kaiser Permanente Washington Health Research Institute (US)
- Swedish Medical Center (US)
- Corresponding author
- Lee, Cecilia S.
- ORCID
- Venue
- American Journal of Ophthalmology
- Publisher
- Elsevier BV
- Published
- 2023-05
- Volume
- 249
- Pages
- 90-98
- ISSN
- 0002-9394 (ISSN-L)
- PMC
- PMC10106379
- OpenAlex
- W4311256030
- Cited by
- 25
- References
- 46
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 7 · 2023: 1
- FWCI
- 2.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 291 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- American Journal of Ophthalmology (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Research to Prevent Blindness (R01AG060942, K23EY029246)
- Alzheimer's Drug Discovery Foundation
- Nvidia
- Health Services Research and Development
- Carl Zeiss Meditec AG (K23EY029246)
- Santen (K23EY029246)
- National Institutes of Health (DP5OD029610, OT2OD032644)
- Genentech (K23EY029246)
- National Institute on Aging (U01AG006781, U19AG066567, R01AG060942)
- National Eye Institute (K23EY029246)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- diabetic retinopathy, dementia, Alzheimer's disease, type 2 diabetes, diabetes severity, microalbuminuria, glycemia, renal function, older adults
- MeSH terms
- Adult, Alzheimer Disease, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Female, Humans, Male, Prospective Studies, Retrospective Studies, Risk Factors
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