Abstract

Background: The prevalence of diabetic retinopathy (DR) is higher in elderly patients with type 2 diabetes mellitus (T2DM) than the younger adult population, and the associated factors involved may be different between these two groups. This study aimed to investigate the prevalence and associated factors of DR in the elderly and younger adult population with T2DM.

Methods: The study recruited 428 patients with T2DM, including 220 elderly subjects and 208 younger adult subjects. All subjects were examined for DR using fundus photography by an experienced ophthalmologist. Data including age, anthropometric measurements, blood pressure, glycemic profiles, lipid profiles, liver enzymes, renal function and microalbuminuria were collected. Simple logistic regression analysis and multiple logistic regression analysis were then performed to analyze the associated factors of DR in the elderly and younger adult groups.

Results: The prevalence of DR was 26% and 16% in elderly and younger adult patients, respectively. In multiple logistic regression analysis, independent factors associated with DR in elderly patients were the presence of albuminuria (OR: 3.47, 95% CI: 1.796.71, p < 0.001) and longer DM duration (OR: 2.56, 95% CI: 1.20–5.46, p = 0.015). For younger adult patients, higher HbA1c level (OR: 3.26, 95% CI: 1.337.99, p = 0.010) was found to be associated with DR.

Conclusion: Microalbuminuria showed a stronger association with DR in elderly patients with T2DM, while high glucose level showed stronger association with DR in the younger adult population. In order to prevent development of retinopathy, these independent factors should be recognized early in T2DM patients according to different age groups.