Abstract
Current guidelines recommend annual screening for cognitive impairment in patients > 65 years with type 2 diabetes (T2D). The most used tool is the mini-mental state evaluation (MMSE). Retinal microperimetry is useful for detecting cognitive impairment in these patients, but there is no information regarding its usefulness as a monitoring tool. We aimed to explore the role of retinal microperimetry in the annual follow-up of the cognitive function of patients with T2D older than 65 years. Materials and Methods: Prospective observational study, comprising patients > 65 years with T2D, attended at our center between March–October 2019. A complete neuropsychological evaluation assessed the baseline cognitive status (mild cognitive impairment, MCI, or normal, NC). Retinal microperimetry (sensitivity, gaze fixation) and MMSE were performed at baseline and after 12 months. Results: Fifty-nine patients with MCI and 22 NC were identified. A significant decline in the MMSE score was observed after 12 months in the MCI group (25.74 ± 0.9 vs. 24.71 ± 1.4; p = 0.001). While no significant changes in retinal sensitivity were seen, all gaze-fixation parameters worsened at 12 months and significantly correlated with a decrease in the MMSE scores. Conclusion: Retinal microperimetry is useful for the monitoring of cognitive decline in patients > 65 years with T2D. Gaze fixation seems a more sensitive parameter for follow-up after 12 months than retinal sensitivity.
Highlights
Current epidemiological data show that type 2 diabetes (T2D) increases the risk of developing Alzheimer’s disease (AD) by two to three times in comparison with the non-diabetic population matched by age and other risk factors [1].Mild cognitive impairment (MCI) represents a deterioration in cognition superior to that observed with normal cognitive decline associated with age
As far as we know, this is the first prospective study to evaluate the usefulness of retinal microperimetry as a tool for screening and for the monitoring of cognitive function in patients with T2D > 65 years old
The baseline evaluation confirmed and extended our previous results that retinal sensitivity and gaze-fixation parameters measured by microperimetry are useful for the detection of cognitive impairment in patients with T2D > 65 years [4,5]
Summary
Mild cognitive impairment (MCI) represents a deterioration in cognition superior to that observed with normal cognitive decline associated with age This decline is not severe enough to cause impaired daily function. The presence of MCI can lead to mismanagement of the specific treatment for T2D This can cause episodes of severe hypoglycemia and increasing cardiovascular mortality, and hypoglycemia itself worsens the patient’s cognitive state, all of which translates into an increase in healthcare costs directly or indirectly [6]. For this reason, it is important to diagnose cognitive impairment in the early stages in patients with T2D. This makes it possible to implement a patientcentered treatment based on its simplicity and the prioritizing of antidiabetic treatments with a low capacity to provoke hypoglycemia
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
