The association between the severity of diabetic retinopathy and cognitive impairment: a cross-sectional study

Purpose To assess the correlation among cognitive impairment (CI) and the degree of diabetic retinopathy (DR). Methods The current analytic cross-sectional study has been carried out on two hundred ten individuals having diabetes mellitus type 2. Individuals were split into 7 groups in order of severity of DR in the worse eye with 30 cases in each group. Cognition function has been determined utilizing mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) tests. Results Comparing the severity of CI using both MMSE and MoCA tests, statistically substantial differences have been discovered among individuals without DR, those having non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) ( p < 0.001). The greatest percentage of severe and moderate CI was seen in the PDR group. Regarding the severity of CI, there has been a statistically substantial difference among NPDR and PDR groups, as well as among no-DR and PDR groups ( p < 0.001). Moreover, the severity of CI in the MMSE and MoCA tests had a negative connection with the grades of DR ( r = − 0.522, P < 0.001 and r = − 0.540, P < 0.001, respectively). Conclusion We discovered a negative connection between the grades of DR and the severity of CI that persisted as a significant finding, showing that patients with more severe DR tended to have higher levels of CI. These results might offer retinal examination or retinal photography as a promising strategy for mass screening of CI in diabetic patients, especially if it is combined with artificial intelligence and telemedicine.