Relationship between retinal neurodysfunction and cognitive impairment in type 2 diabetes: results of the RECOGNISED cross-sectional study
Authors' conclusion
The assessment of retinal neurodysfunction in combination with simple clinical variables appears useful to identify people with diabetes with MCI. This strategy could optimise current screening of MCI in people living with diabetes.
Study context
- Population
- People aged ≥65 years with T2D of over 5 years standing, no previous stroke or neurodegenerative disease, and no overt or only mild-to-moderate non-proliferative DR; European RECOGNISED project
- Participants
- 313 people
- Exposure
- Mild cognitive impairment (MCI) vs normocognition
- MCIn = 185
- Normocognition (NC)n = 128reference
- Outcome
- Identification of MCI by retinal biomarkers combined with simple clinical tests (AUC, sensitivity, specificity)
Methodological detailsbaseline data from the RECOGNISED project, stepwise variable selection (Akaike's information criterion), logistic regression, ROC analysis
- Baseline data from the RECOGNISED project
- Stepwise variable selection (Akaike's information criterion)
- Logistic regression
- ROC analysis
Main finding
As reported in the abstract
Best multivariable model to identify MCI (retinal sensitivity, gaze fixation, photopic b-wave amplitude, pupillary size change after stimulation, years of education, Diabetes Specific Dementia Risk Score (DSDRS), MoCA score)
AUC
0.84
Sensitivity
79.9
Specificity
79.0
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Characteristics of MCI vs NCMCI vs NC · older with MCI | P = 0.006 |
| Characteristics of MCI vs NCMCI vs NC · fewer years of education with MCI | P < 0.001 |
| Characteristics of MCI vs NCMCI vs NC · lower retinal sensitivity with MCI | P = 0.01 |
| Characteristics of MCI vs NCMCI vs NC · less capacity of gaze fixation with MCI | P ≤ 0.001 |
| Characteristics of MCI vs NCBetween MCI and NC · pupillary area ratio differed | P = 0.002 |
| Characteristics of MCI vs NCBetween MCI and NC · photopic b-wave amplitude differed | P = 0.03 |
Cognitive domains in MCI
- Visuo-construction domain most affected in MCI; its impairment independently related to retinal sensitivity and gaze fixation
Original publication
Relationship between retinal neurodysfunction and cognitive impairment in type 2 diabetes: results of the RECOGNISED cross-sectional study. Diabetologia. Published 29 January 2026. doi:10.
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