Association of retinal arteriolar dilatation with lower verbal memory: the Edinburgh Type 2 Diabetes Study.


Journal Article

AIMS/HYPOTHESIS: Retinal vascular calibre changes may reflect early subclinical microvascular disease in diabetes. Because of the considerable homology between retinal and cerebral microcirculation, we examined whether retinal vascular calibre, as a proxy of cerebral microvascular disease, was associated with cognitive function in older people with type 2 diabetes. METHODS: A cross-sectional analysis of 954 people aged 60-75 years with type 2 diabetes from the population-based Edinburgh Type 2 Diabetes Study was performed. Participants underwent standard seven-field binocular digital retinal photography and a battery of seven cognitive function tests. The Mill Hill Vocabulary Scale was used to estimate pre-morbid cognitive ability. Retinal vascular calibre was measured from an image field with the optic disc in the centre using a validated computer-based program. RESULTS: After age and sex adjustment, larger retinal arteriolar and venular calibres were significantly associated with lower scores for the Wechsler Logical Memory test, with standardised regression coefficients -0.119 and -0.084, respectively (p < 0.01), but not with other cognitive tests. There was a significant interaction between sex and retinal vascular calibre for logical memory. In male participants, the association of increased retinal arteriolar calibre with logical memory persisted (p < 0.05) when further adjusted for vocabulary, venular calibre, depression, cardiovascular risk factors and macrovascular disease. In female participants, this association was weaker and not significant. CONCLUSIONS/INTERPRETATION: Retinal arteriolar dilatation was associated with poorer memory, independent of estimated prior cognitive ability in older men with type 2 diabetes. The sex interaction with stronger findings in men requires confirmation. Nevertheless, these data suggest that impaired cerebral arteriolar autoregulation in smooth muscle cells, leading to arteriolar dilatation, may be a possible pathogenic mechanism in verbal declarative memory decrements in people with diabetes.

Full Text

Duke Authors

Cited Authors

  • Ding, J; Strachan, MWJ; Fowkes, FGR; Wong, TY; Macgillivray, TJ; Patton, N; Gardiner, TA; Deary, IJ; Price, JF

Published Date

  • July 2011

Published In

Volume / Issue

  • 54 / 7

Start / End Page

  • 1653 - 1662

PubMed ID

  • 21455727

Pubmed Central ID

  • 21455727

Electronic International Standard Serial Number (EISSN)

  • 1432-0428

Digital Object Identifier (DOI)

  • 10.1007/s00125-011-2129-1


  • eng

Conference Location

  • Germany