الفهرس 
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Abstract
Diabetes is a very common disease among elderly persons, afflicting about 20% of adults aged 65-75 years and 40% of adults above 80 years old.
Patients with diabetes often develop ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies. The most common and potentially most blinding of these complications, however, is diabetic retinopathy.
Type 2 diabetes is associated with an increased risk of age-related cognitive impairment and decline in addition to higher incidences of stroke and dementia.
Relatively little is known about the risk factors associated with the deleterious effects of type 2 diabetes on accelerated cognitive ageing, although cerebral microvascular disease may be important.
Often elderly patients have cognitive impairments, limitations in their activities of daily living, undiagnosed depression and difficult social issues that may contribute to the development of complications.
The Mini-Mental State Examination (MMSE) is often used as a screening for dementia and is included as a general mental assessment for possible cognitive pathology.
Retinal and cerebral small vessels share similar embryological origin, size, structure, and physiological characteristics (including the blood-brain and blood-retinal barrier).
Previous studies have found a significant association between the presence of microaneurysms and reduced performance on measures of fluid intelligence, processing speed, and attention ability in young adults with type 1 diabetes and between retinopathy and risk of cognitive impairment and decline in the general population, but not enough studies about the relationship between diabetic retinopathy (DR) and cognition in older people with type 2 diabetes have been done.
The aim of our study was to find if there was a significant relationship between diabetic retinopathy and cognitive decline or not.
Our study was performed on 60 elderly subjects aged 65 years and over were classified into 3 groups; 1st group as 20 non diabetic subjects, 2nd group was 20 diabetic patients without DR and 3rd group was diabetic patients with DR. We used fluorescein angiography for grading the severity of DR and Mini Mental State Examination (MMSE) to assess the cognition. All patients were subjected to full history taking, general examination and laboratory investigations
• The following results were found:
- There was a significant relationship between diabetic retinopathy and cognitive decline (p value = 0.006).
- There was a significant negative correlation between the increasing the severity of diabetic retinopathy and increasing the severity of cognitive decline (rs was -0.590 with p value = 0.006).
- The increasing the duration of diabetes in cases having DR was associated with cognitive decline(p value = 0.020).
- The increasing the duration of diabetes was associated with increasing severity of DR (p value = 0.005) .
- There was a significant relationship between DR and diabetic nephropathy (p value =0.017) .