Frontiers in medicine · 2026
Diabetic retinopathy and the risk of all-cause dementia, Alzheimer's disease, and vascular dementia: a systematic review and meta-analysis.
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Hu Haoshen, Wang Yue, Xu Yidan, Chen Lixun
Аннотация
BACKGROUND: Existing evidence on the association between diabetic retinopathy (DR) and the risk of all-cause dementia (ACD), Alzheimer's disease (AD), and vascular dementia (VD) remains inconsistent. To address this gap, we performed a systematic review and meta-analysis to quantitatively assess the relationship between DR patients and subsequent dementia risk, aiming to inform evidence-based prevention strategies.
METHODS: We systematically searched PubMed, Embase, and Web of Science for cohort studies investigating the association between DR and the risk of ACD, AD, and VD. The searches covered all available literature from the inception of database to September 2025. After literature screening, data extraction, and risk-of-bias assessment, meta-analysis was conducted using Stata 14.0. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.
RESULTS: A total of 10 studies involving 1,720,128 participants were included. The meta-analysis showed that DR was significantly associated with higher risks of ACD (HR = 1.24, 95%CI [1.14, 1.36], p < 0.00001), VD (HR = 1.20, 95%CI [1.05, 1.37], p = 0.009), and AD (HR = 1.23, 95%CI [1.11, 1.37], p < 0.00001).
CONCLUSION: Current evidence indicates that DR is associated with an elevated risk of ACD, AD, and VD. Clinically, early screening and regular monitoring of cognitive function should be strengthened in patients with DR, and these assessments should be integrated into comprehensive diabetes care. Given the inherent limitations of this study, further high-quality prospective cohort studies are needed to confirm these findings.
METHODS: We systematically searched PubMed, Embase, and Web of Science for cohort studies investigating the association between DR and the risk of ACD, AD, and VD. The searches covered all available literature from the inception of database to September 2025. After literature screening, data extraction, and risk-of-bias assessment, meta-analysis was conducted using Stata 14.0. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.
RESULTS: A total of 10 studies involving 1,720,128 participants were included. The meta-analysis showed that DR was significantly associated with higher risks of ACD (HR = 1.24, 95%CI [1.14, 1.36], p < 0.00001), VD (HR = 1.20, 95%CI [1.05, 1.37], p = 0.009), and AD (HR = 1.23, 95%CI [1.11, 1.37], p < 0.00001).
CONCLUSION: Current evidence indicates that DR is associated with an elevated risk of ACD, AD, and VD. Clinically, early screening and regular monitoring of cognitive function should be strengthened in patients with DR, and these assessments should be integrated into comprehensive diabetes care. Given the inherent limitations of this study, further high-quality prospective cohort studies are needed to confirm these findings.