The influence of diabetic retinopathy on the risk of dementia: A nationwide cohort study.

We evaluated the impact of diabetic retinopathy (DMR) on dementia using clinical data from the Korean National Health Insurance Service. A nationwide, population-based retrospective cohort of 784,205 individuals over the age of 45 was analyzed. DMR diagnoses were confirmed using diagnostic and procedure codes. Covariate data, such as age, sex, income level, visual acuity, systemic and ophthalmic comorbidities, and behavioral factors, were collected from health screenings and claims data. Participants were followed until December 2017, and dementia cases were identified through registered diagnostic codes and medication prescriptions. The association between DMR and dementia was assessed using a multivariable-adjusted Cox proportional hazards model. Over an average follow-up of 10.9 ± 2.7 years, 53,934 patients were newly diagnosed with dementia. Those with DMR had a significantly higher risk of developing dementia (HR = 2.74; 95% CI = 2.44-3.08) compared to those without DMR. The risk was notably higher in patients younger than 65 years (HR = 4.07; 95% CI = 3.35-4.94) than in those aged 65 and older (HR = 2.71; 95% CI = 2.37-3.11). These findings suggest that DMR significantly increases the risk of dementia, particularly in younger patients.