{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T19:31:02Z","timestamp":1783971062406,"version":"3.55.0"},"reference-count":75,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":136,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) is linked to both diabetic retinopathy (DR) and cognitive impairment, yet the consistency and modifiers of this relationship remain unclear. This systematic review and meta\u2010analysis are aimed at quantifying the association between DR and cognitive dysfunction in T2DM and explore variations by cognitive subtype, diabetes duration, follow\u2010up time, and assessment methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, Web of Science, and Chinese databases from 2000 to March 2025. Observational studies comparing cognitive outcomes in T2DM patients with and without DR were included. Data were pooled using random\u2010effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010eight studies were included. Cross\u2010sectional studies showed a strong association (OR = 2.04, 95% CI: 1.72\u20132.42;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.0\n                      <jats:italic>%<\/jats:italic>\n                      ), whereas cohort studies showed a modest but significant association (OR = 1.13, 95% CI: 1.01\u20131.26;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 85.2\n                      <jats:italic>%<\/jats:italic>\n                      ). The strongest associations were observed for mild cognitive impairment (cross\u2010sectional OR = 2.15) and dementia (cross\u2010sectional OR = 2.20; cohort OR = 1.17). Longer diabetes duration (\u2265\u200910 years) strengthened the association in cross\u2010sectional studies (OR = 2.05), but not in cohort studies. Extended follow\u2010up (\u2265\u200910 years) significantly increased the effect in cohort studies (OR = 1.91).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DR is significantly associated with cognitive impairment in T2DM, particularly dementia and its subtypes. The association is influenced by study design, diabetes duration, follow\u2010up time, and assessment method. DR may serve as a research\u2010level risk signal for cerebral microvascular damage, warranting further prospective studies to validate its clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jdr\/1328324","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:39:52Z","timestamp":1779082792000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diabetic Retinopathy and Cognitive Dysfunction in Type 2 Diabetes Mellitus: A Systematic Review and Meta\u2010Analysis of Epidemiological Associations and Clinical Implications"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6143-7789","authenticated-orcid":false,"given":"Ye","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7344-8557","authenticated-orcid":false,"given":"Yining","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5292-5235","authenticated-orcid":false,"given":"Lixiao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7356-868X","authenticated-orcid":false,"given":"Yuzhu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5226-7917","authenticated-orcid":false,"given":"Chuyi","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0513-0580","authenticated-orcid":false,"given":"Fangfang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9798-2400","authenticated-orcid":false,"given":"Ying","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"e_1_2_12_1_2","volume-title":"Over 250 Million People Worldwide Unaware They Have Diabetes","author":"International Diabetes Federation","year":"2025"},{"key":"e_1_2_12_2_2","unstructured":"International Diabetes Federation IDF Global Clinical Practice Recommendations for Managing Type 2 Diabetes 2025 Accessed April 7 2025 https:\/\/idf.org\/media\/uploads\/2025\/04\/IDF_Rec_2025.pdf."},{"key":"e_1_2_12_3_2","first-page":"2077","article-title":"Worldwide Trends in Diabetes Prevalence and Treatment From 1990 to 2022: a Pooled Analysis of 1108 Population-Representative Studies With 141 Million Participants","volume":"2024","author":"NCD Risk Factor Collaboration (NCD-Ris C)","journal-title":"Lancet"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)62124-3"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30489-7"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-1588"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30367-6"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/4591938"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.06.3060"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.65.8.1066"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2018-312807"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-018-4692-1"},{"key":"e_1_2_12_13_2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1136\/jnnp.74.1.70","article-title":"Increased Blood-Brain Barrier Permeability in Type II Diabetes Demonstrated by Gadolinium Magnetic Resonance Imaging","volume":"74","author":"Starr J. 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