Eye Disease Linked To Weakened Brain Power In People With Diabetes

Main Category: Eye Health / Blindness
Also Included In: Diabetes
Article Date: 09 Mar 2010 - 0:00 PDT

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Diabetic retinopathy, the leading cause of blindness in the UK's working-age population, could be associated with poorer memory and diminished brain power in people with Type 2 diabetes, according to new research¹ announced this week at leading health charity Diabetes UK's Annual Professional Conference.

The study looked at 1,066 people with Type 2 diabetes aged between 60 and 75 years old. Participants completed seven tests looking at memory, logic and concentration to establish their level of brain function. Those with retinopathy had worse average scores on most of the individual tests as well as on general cognitive ability compared to those without the condition. The results were independent of age and gender.

Mrs Jie Ding from the University of Edinburgh, who helped lead the research (as part of the Edinburgh Type 2 Diabetes Study), said: "These findings suggest that the severity of diabetic retinopathy is independently associated with cognitive dysfunction in people with Type 2 diabetes aged between 60 and 75 years old. This can mean either that cerebral microvascular disease, as indexed by retinopathy, may lead to cognitive decrements in old age or that poorer cognitive ability makes diabetes management more difficult, and in turn promotes the development of cerebral microvascular disease. It is also possible that a third unidentified factor is causing both diabetic retinopathy and the cognitive changes.

"The 4-year follow-up data of the ET2DS may clarify the temporal relationship of these associations. The seven neuropsychological tests assessed people's memory for faces, recollection of linear stories, vocabulary, the ability to re-organise a sequence of letters as well as some other cognitive functions.

"The results provide insights into the specific underlying mechanism of cognitive dysfunction in Type 2 diabetes, which is possibly due to a break-down of blood brain barrier (similar to changes in blood-retinal barrier as seen in diabetic retinopathy). From a clinical perspective, cognitive impairment in Type 2 diabetes may therefore be amenable to treatment and preventive strategies targeted at this small vessel disease."

Dr Iain Frame, Director of Research at Diabetes UK, said: "Retinopathy is an indicator of cerebral microvascular disease, which is when the small blood vessels in the brain are narrowed or blocked off and lead to a reduction in blood supply to the brain tissues. There is already evidence to suggest that cerebral microvascular disease and Type 2 diabetes may exacerbate the effects of aging on cognitive function. This study adds to this body of research as it suggests that diabetic retinopathy is linked to estimated life time cognitive decline in older people with Type 2 diabetes.

"Cognitive decline is the decline of brain functions such as memory, attention, and planning.

"If anyone with diabetes is concerned about their health they should consult their GP or diabetes healthcare professional."

The study found that participants with moderate to severe retinopathy performed worse in the non-verbal memory, mental flexibility and processing speed tests compared to those with mild or no retinopathy. It also suggested that the male participants with moderate to severe retinopathy may be more prone to cognitive decline in old age.

There are 2.35 million people diagnosed with Type 2 diabetes in the UK and up to 500,000 who have the condition but do not know it. Almost two thirds of the 2.35 million people with Type 2 diabetes develop some degree of retinopathy within 20 years of being diagnosed.

Notes

1. Diabetic retinopathy and cognitive decline in older people with Type 2 diabetes J Ding1, MWJ Strachan2, RM Reynolds3, BM Frier4, FGR Fowkes1, IJ Deary5, AJ Lee7, P Halpin6, J McKnight6, K Swa6 and JF Price1 1Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK, 2Metabolic Unit, Western General Hospital, Edinburgh, UK, 3Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK, 4Department of Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK, 5Department of Psychology, University of Edinburgh, Edinburgh, UK, 6Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, UK, 7Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, UK

2. The Diabetes UK Annual Professional Conference (APC) is taking place from 3 to 5 March 2010 at the ACC Liverpool. It is the UK's largest diabetes conference with over 3,000 healthcare professionals attending.

3. Diabetes UK is the leading charity for the three million people in the UK with diabetes. We aim to spend more than £6.5 million on research in 2010 as well as campaigning and providing information and support. For more information visit http://www.diabetes.org.uk

4. In the UK, there are currently 2.6 million people diagnosed with diabetes and it is estimated that up to half a million people have Type 2 diabetes but do not know it.

5. The Diabetes UK Careline (0845 120 2960) offers information and support on any aspect of managing diabetes. The line is a low cost number and opens Monday to Friday between 9am and 5pm (operates a translation service). Recorded information on a number of diabetes-related topics is also available on this number 24 hours a day.

6. Supporting our work to fund vital research into the care, treatment and hopefully a cure for diabetes as a Diabetes UK Supporting Member entitles you to a range of benefits including our bi-monthly magazine Balance, reliable information booklets on diabetes, our confidential Diabetes UK Careline, over 400 local Diabetes UK support groups, and access to an exclusive personalised Supporting Members Area on our website.

Source
Diabetes UK