The association between diabetic retinopathy, cognitive impairment, and quality of life – a cross sectional study

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-07-01 DOI:10.1016/j.deman.2023.100142

Parvathy Geetha Sajeev , Srikanth Krishnagopal , Karthick Subramanian

{"title":"The association between diabetic retinopathy, cognitive impairment, and quality of life – a cross sectional study","authors":"Parvathy Geetha Sajeev , Srikanth Krishnagopal , Karthick Subramanian","doi":"10.1016/j.deman.2023.100142","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Diabetic retinopathy (DR), a microangiopathy caused by Type 2 Diabetes Mellitus (T2DM), is associated with significant visual disability leading to suboptimal quality of life. Retinal microvasculature changes can reflect similar changes in the grey matter and blood-brain barrier. Microvascular changes in the brain are associated with cognitive dysfunction. The present study aimed to find the association between Diabetic Retinopathy (DR) and Cognitive Impairment (CI) and its relationship with Quality of Life (QoL).</p></div><div><h3>Methodology</h3><p>A cross-sectional observational study was conducted in a tertiary care hospital among patients (aged 18 years and above) with pre-existing T2DM as per Standards of Care in Diabetes-2023 criteria. Patients with visual acuity less than 3/60, or education below 6th grade, or with comorbid mental or neurocognitive disorders illness were excluded from the study. DR grading was done using the Early Treatment Diabetic Retinopathy Study (ETDRS) criteria. Cognitive functions and quality of life were measured using Montreal cognitive assessment (MoCA) and World Health Organization – Quality of Life scale – brief version (WHO-QOL BREF). The primary outcome measures (cognitive impairment and quality of life) were compared between patients with DR (DR+) and patients without DR (DR-). A <em>P</em> < 0.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>Diabetic retinopathy was diagnosed in 48.5% (83 out of 171) of the sample. The DR+ group were predominantly male, significantly older, had comorbid immature cataract and hypertension than the DR- group. Also, the DR+ group had significantly reduced scores in all domains of MoCA and QoL. among patients with DR, those with severe and moderate NPDR had more cognitive impairment than mild NPDR. Age and duration of diabetes did not correlate with MoCA and QoL scores.</p></div><div><h3>Conclusion</h3><p>The presence of diabetic retinopathy is associated with cognitive impairment and reduced quality of life in this study population. The association is independent of the age of patient and the duration of diabetes mellitus.</p></div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S266697062300015X","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Diabetic retinopathy (DR), a microangiopathy caused by Type 2 Diabetes Mellitus (T2DM), is associated with significant visual disability leading to suboptimal quality of life. Retinal microvasculature changes can reflect similar changes in the grey matter and blood-brain barrier. Microvascular changes in the brain are associated with cognitive dysfunction. The present study aimed to find the association between Diabetic Retinopathy (DR) and Cognitive Impairment (CI) and its relationship with Quality of Life (QoL).

Methodology

A cross-sectional observational study was conducted in a tertiary care hospital among patients (aged 18 years and above) with pre-existing T2DM as per Standards of Care in Diabetes-2023 criteria. Patients with visual acuity less than 3/60, or education below 6th grade, or with comorbid mental or neurocognitive disorders illness were excluded from the study. DR grading was done using the Early Treatment Diabetic Retinopathy Study (ETDRS) criteria. Cognitive functions and quality of life were measured using Montreal cognitive assessment (MoCA) and World Health Organization – Quality of Life scale – brief version (WHO-QOL BREF). The primary outcome measures (cognitive impairment and quality of life) were compared between patients with DR (DR+) and patients without DR (DR-). A P < 0.05 was considered statistically significant.

Results

Diabetic retinopathy was diagnosed in 48.5% (83 out of 171) of the sample. The DR+ group were predominantly male, significantly older, had comorbid immature cataract and hypertension than the DR- group. Also, the DR+ group had significantly reduced scores in all domains of MoCA and QoL. among patients with DR, those with severe and moderate NPDR had more cognitive impairment than mild NPDR. Age and duration of diabetes did not correlate with MoCA and QoL scores.

Conclusion

The presence of diabetic retinopathy is associated with cognitive impairment and reduced quality of life in this study population. The association is independent of the age of patient and the duration of diabetes mellitus.

查看原文本刊更多论文

糖尿病视网膜病变、认知障碍和生活质量之间的关系——一项横断面研究

背景:糖尿病视网膜病变(DR)是一种由2型糖尿病(T2DM)引起的微血管病变，与严重的视力障碍相关，导致生活质量欠佳。视网膜微血管的变化可以反映灰质和血脑屏障的类似变化。大脑微血管的变化与认知功能障碍有关。本研究旨在探讨糖尿病视网膜病变(DR)与认知功能障碍(CI)的关系及其与生活质量(QoL)的关系。方法:根据糖尿病护理标准-2023标准，在一家三级医院对已有T2DM的患者(18岁及以上)进行了横断面观察性研究。视力低于3/60，或教育程度低于6年级，或伴有精神或神经认知障碍疾病的患者被排除在研究之外。DR分级采用早期治疗糖尿病视网膜病变研究(ETDRS)标准。认知功能和生活质量采用蒙特利尔认知评估(MoCA)和世界卫生组织-生活质量量表-简要版(WHO-QOL BREF)进行测量。比较DR患者(DR+)和无DR患者(DR-)的主要结局指标(认知功能障碍和生活质量)。A & P;0.05认为有统计学意义。结果171例患者中有83例(48.5%)诊断为糖尿病视网膜病变。DR+组以男性为主，年龄明显大于DR-组，合并有未成熟白内障和高血压。DR+组在MoCA和QoL各领域得分均显著降低。在DR患者中，重度和中度NPDR患者比轻度NPDR患者有更多的认知障碍。年龄和糖尿病病程与MoCA和QoL评分无关。结论在本研究人群中，糖尿病视网膜病变的存在与认知功能障碍和生活质量下降有关。这种相关性与患者的年龄和糖尿病病程无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.