Skip to main content

Association of Cognitive Function and Retinal Neural and Vascular Structure in Type 1 Diabetes.

Citation
Fickweiler, W., et al. “Association Of Cognitive Function And Retinal Neural And Vascular Structure In Type 1 Diabetes.”. The Journal Of Clinical Endocrinology And Metabolism, pp. 1139-1149.
Center Joslin Diabetes Center
Author Ward Fickweiler, Emily A Wolfson, Samantha M Paniagua, Marc Gregory Yu, Atif Adam, Vanessa Bahnam, Konstantina Sampani, I-Hsien Wu, Gail Musen, Lloyd P Aiello, Hetal Shah, Jennifer K Sun, George L King
Keywords Cognition, Diabetic complications, Diabetic retinopathy, ocular imaging, type 1 diabetes
Abstract

CONTEXT: Cognitive dysfunction is a growing and understudied public health issue in the aging type 1 diabetic population and is difficult and time-consuming to diagnose. Studies in long duration type 1 diabetes have reported the presence of proliferative diabetic retinopathy was associated with cognitive dysfunction.

OBJECTIVE: This study assessed whether structural and vascular abnormalities of the retina, representing an extension of the central nervous system, are associated with cognitive impairment and other complications of type 1 diabetes.

METHODS: An observational cross-sectional study of individuals with 50 or more years of type 1 diabetes (Joslin Medalist Study) was conducted at a university hospital in the United States. The study included 129 participants with complete cognitive testing. Validated cognitive testing measures included psychomotor speed, and immediate, and delayed memory. Optical coherence tomography (OCT) and OCT angiography (OCTA) were performed to obtain neural retinal layer thicknesses and vascular density for superficial (SCP) and deep retinal capillary plexus (DCP). Multivariable modeling was adjusted for potential confounders associated with outcomes in unadjusted analyses.

RESULTS: Decreased vessel density of the SCP and DCP was associated with worse delayed memory (DCP: P = .002) and dominant hand psychomotor speed (SCP: P = .01). Thinning of the retinal outer nuclear layer was associated with worse psychomotor speed both in nondominant and dominant hands (P = .01 and P = .05, respectively). Outer plexiform layer thickness was associated with delayed memory (P = .04).

CONCLUSION: These findings suggest that noninvasive retinal imaging using OCT and OCTA may assist in estimating the risks for cognitive dysfunction in people with type 1 diabetes.

Year of Publication
2021
Journal
The Journal of clinical endocrinology and metabolism
Volume
106
Issue
4
Number of Pages
1139-1149
Date Published
03/2021
ISSN Number
1945-7197
DOI
10.1210/clinem/dgaa921
Alternate Journal
J Clin Endocrinol Metab
PMID
33378459
PMCID
PMC7993575
Download citation