Prevalence, risk factors, and early prediction of cognitive impairment in patients with diabetes mellitus: a systematic review and meta-analysis
Abstract
Introduction: Diabetes mellitus (DM) substantially increases the risk of cognitive impairment (CI). Currently, systematic evidence regarding its prevalence, risk factors, and early predictive models remains scarce, hindering the development of targeted preventive strategies. Thus, this meta-analysis aimed to comprehensively estimate the global CI prevalence in individuals with DM, identify associated risk factors, and assess the performance and potential application of early predictive models.
Methods: Embase, Web of Science, the Cochrane Library, and PubMed were searched up to May 2025 to include observational studies reporting on the prevalence, risk factors, and predictive models of CI in individuals with DM. The Agency for Healthcare Research and Quality scale and the Newcastle-Ottawa Scale were employed to appraise the quality of included studies. Meta-analyses of prevalence, risk factors, and c-indices of predictive models were carried out using R 4.5.0. This study was registered in PROSPERO (CRD420250632808).
Results: In total, 41 studies involving 18,768 patients with DM were included. After excluding three case-control studies, 38 studies were eligible for prevalence synthesis. Meta-analysis demonstrated an overall CI prevalence of 40.80% (95% CI: 33.91%-47.87%) among DM patients. Identified risk factors included demographic factors: age (odds ratio [OR]=2.18 95% confidence interval [CI]: 1.37-3.48), low income (OR = 2.25, 95%CI:1.28-3.96), and unmarried status (OR…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 18,768 participants or records.
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