Retinography as a marker of the progression of cognitive impairment and/or dementia in older people with type II diabetes mellitus

Introduction The aging population increases type 2 diabetes mellitus (T2DM) prevalence and consequently heightens related complications, including dementia and microvascular disease. This study examined the relationship between diabetic retinopathy (DR) and cognitive decline in adults with T2DM. Methods A prospective cohort study was conducted with 328 individuals aged ≥60 years with T2DM in Córdoba, Spain. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline, 6, and 12 months, and retinal imaging identified DR. Clinical and sociodemographic data were collected. Results MMSE scores declined from 28.31 (SD = 2.07) at baseline to 27.47 (SD = 2.43) at 12 months ( p < 0.001). At 12 months, participants with DR exhibited significantly lower MMSE scores (26.75 ± 2.93 vs. 27.58 ± 2.27; p = 0.03). Multimorbidity and hypertension were associated with accelerated cognitive decline. Discussion DR appears as a marker of microvascular-related cognitive decline in T2DM, highlighting the value of combined ophthalmologic and cognitive monitoring.