CORRELATION OF SEVERITY OF DIABETIC RETINOPATHY WITH COGNITIVE IMPAIRMENT IN TYPE 2 DIABETICS

Abstract

BACKGROUND AND AIM To assess the severity of diabetic retinopathy and to determine the association between diabetic retinopathy and cognitive impairment in type 2 diabetes mellitus patients. METHODS A cross-sectional analytical study was conducted on 215 diabetic patients for a period of 6 months of which 83 had no DR while 132 had DR; the Montreal Cognitive Assessment -B (MOCA-B) test was administered and evaluated for cognitive impairment. RESULTS Out of 215 patients, 111(51.62%) individuals were aged <60 years and 104 (48.37%) were above 60 years of age. The study involved 119 males (55.34%) and 96 (44.65%) females of which 83(38.60%) of them had no DR and associated hypertension and 132 (61.39%) had DR associated with hypertension. 90 (41.86%) had NPDR and 42(19.53%) had PDR. It was found that males had a higher preponderance towards PDR while females had a slightly higher preponderance towards NPDR. 18 individuals (8.37%) had associated hypertension among the NPDR group and 42(19.53%) patients had hypertension in PDR group. Patients, after administering the Montreal cognitive assessment scale were evaluated for cognitive impairment and was found that CI was more in >60 years age group (59.44%) and in males. Duration of diabetes and its association with presence of diabetic retinopathy and cognitive impairment was found to be of significance (9.66±6.16, P=0.0004) 109(76.22%) patients with cognitive impairment had hypertension. 37(25.87%) patients with PDR had cognitive impairment (P=0.001) CONCLUSION Older age and progressive DR is associated with development of cognitive impairment especially in the abstraction and delayed recall domains in diabetic retinopathy patients. Hence heightened cognitive impairment prevalence in diabetics with retinopathy is a warning sign of cerebral abnormalities.