{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:28:42Z","timestamp":1792711722804,"version":"4.5.0"},"reference-count":45,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":4019,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2010,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Cerebral microvascular disease associated with type 2 diabetes may exacerbate the effects of aging on cognitive function. A considerable homology exists between the retinal and cerebral microcirculations; a hypothesized association between diabetic retinopathy (DR) and cognitive decline was examined in older people with type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>In the population-based Edinburgh Type 2 Diabetes Study, 1,046 men and women aged 60\u201375 years with type 2 diabetes underwent standard seven-field binocular digital retinal photography and a battery of seven cognitive function tests. A general cognitive ability score (g) was generated by principal components analysis. The Mill-Hill Vocabulary Scale was used to estimate premorbid cognitive ability. DR was graded using a modification of the Early Treatment of Diabetic Retinopathy Scale.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>After age and sex adjustment, a significant relationship was observed with increasing severity of DR (none, mild, and moderate to severe) for most cognitive measures. Participants with moderate-to-severe retinopathy had the worst g and the worst performances on the individual tests. There was a significant interaction between sex and retinopathy for g. In male subjects, the associations of retinopathy with g (and with tests of verbal fluency, mental flexibility, and processing speed but not memory and nonverbal reasoning) persisted (P &amp;lt; 0.05) when further adjusted for vocabulary (to estimate lifetime cognitive decline), depression, sociodemographic characteristics, cardiovascular risk factors, and macrovascular disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>DR was independently associated with estimated lifetime cognitive decline in older men with type 2 diabetes, supporting the hypothesis that cerebral microvascular disease may contribute to their observed accelerated age-related cognitive decline. A sex interaction with stronger findings in men requires further confirmation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/db10-0752","type":"journal-article","created":{"date-parts":[[2010,8,27]],"date-time":"2010-08-27T00:24:04Z","timestamp":1282868644000},"page":"2883-2889","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":130,"title":["Diabetic Retinopathy and Cognitive Decline in Older People With Type 2 Diabetes"],"prefix":"10.2337","volume":"59","author":[{"given":"Jie","family":"Ding","sequence":"first","affiliation":[{"name":"Centre for Population Health Sciences, University of Edinburgh, Edinburgh, U.K.;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.J.","family":"Strachan","sequence":"additional","affiliation":[{"name":"Metabolic Unit, Western General Hospital, Edinburgh, U.K.;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, U.K.;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian M.","family":"Frier","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Royal Infirmary, Edinburgh, U.K.;"},{"name":"Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, U.K.;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian J.","family":"Deary","sequence":"additional","affiliation":[{"name":"Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, U.K.;"},{"name":"Department of Psychology, University of Edinburgh, Edinburgh, U.K.;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Fowkes R.","family":"Gerald","sequence":"additional","affiliation":[{"name":"Centre for Population Health Sciences, University of Edinburgh, Edinburgh, U.K.;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Section of Population Health, University of Aberdeen, Aberdeen, U.K.;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"McKnight","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Halpin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Swa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Princess Alexandra Eye Pavilion, 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