Cognitive impairment in diabetes mellitus: an exploratory study
DOI:
https://doi.org/10.18203/2349-3933.ijam20223401Keywords:
Cognitive function, Brain, Diabetes, MMSEAbstract
Background: Present study was conducted to estimate the prevalence and evaluate predictors of cognitive function impairment in patients with type 2 diabetes mellitus.
Methods: This prevalence study was conducted over one year at a tertiary care teaching hospital in central India. Known cases of type 2 diabetes mellitus of more than one year of duration of illness were considered eligible. Patients with past history of head injury, seizure episode, stroke, chronic kidney disease, those taking antidepressant/antipsychotic treatment and those with pre-existing dementia were excluded. Mini-mental state examination was employed for estimation of the cognitive function. Clinical history, examination and biochemical findings were also evaluated.
Results: In all, total 332 patients with mean age of 61.33±11.33 years were studied. Two hundred patients (60.24%) were below 60 years, and 132 patients (39.76%) were over 60 years of age. Two hundred sixteen patients (65.06%) were males, and 116 (34.96%) were females. The mean duration of diabetes mellitus (DM) was 10.17±4.81 years. The mean MMSE score was 22.69±5.26 and 81 (24.4%) patients were observed to have cognitive impairment. The difference in cognitive function between those below 60 years and above 60 years was statistically significant (p=0.0214). Duration of illness was also a significant factor (p=0.0394). But gender was not observed to affect the cognitive function significantly (p=0.2497).
Conclusions: Cognitive impairment is common amongst diabetics and is directly related to age and duration of diabetes amongst them; while gender does not influence the cognitive function amongst diabetics.
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References
Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation. Available at: https://www.who.int/ diabetes/publications/Definition%20and%20diagnosis%20of%20diabetes_new.pdf. Accessed on 20 November 2021.
Saeedi P, Salpea P, Karuranga S, Petersohn I, Malanda B, Gregg EW, et al. Mortality attributable to diabetes in 20-79 years old adults, 2019 estimates: Results from the International Diabetes Federation Diabetes Atlas. Diab Res Clin Pract. 2020;162:108086.
Zhou B, Lu Y, Hajifathalian K, Bentham J, Di Cesare M, Danaei G, et al. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4• 4 million participants. Lancet. 2016;387(10027):1513-30.
Basit A, Fawwad A, Qureshi H, Shera AS. Prevalence of diabetes, pre-diabetes and associated risk factors: second National diabetes survey of pakistan (NDSP), 2016-2017. BMJ. 2018;8(8): e020961.
Chan JC, Lim LL, Wareham NJ, Shaw JE, Orchard TJ, Zhang P, et al. Commission on diabetes: using data to transform diabetes care and patient lives. Lancet. 2020;396(10267):2019-82.
Pan A, Lucas M, Sun Q, van Dam RM, Franco OH, Manson JE, et al. Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Int Med. 2010;170(21):1884-91.
Pasquier F. Diabetes and cognitive impairment: how to evaluate the cognitive status?. Diab Metab. 2010;36:S100-5.
Paul KC, Jerrett M, Ritz B. Type 2 diabetes mellitus and Alzheimer’s disease: overlapping biologic mechanisms and environmental risk factors. Curr Environ Health Rep. 2018;5(1):44-58.
Umegaki H. Type 2 diabetes as a risk factor for cognitive impairment: current insights. Clin Interven Aging. 2014;9:1011.
You Y, Liu Z, Chen Y, Xu Y, Qin J, Guo S, et al. The prevalence of mild cognitive impairment in type 2 diabetes mellitus patients: a systematic review and meta-analysis. Acta Diabetol. 2021; 58(6):671-85.
Middleton LE, Yaffe K. Promising strategies for the prevention of dementia. Arch Neurol. 2009;66(10): 1210-5.
Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diab Endocrinol. 2014;2(10):819-29.
Awad N, Gagnon M, Messier C. The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive function. J Clin Exper Neuropsychol. 2004;26(8):1044-80.
Saczynski JS, Jónsdóttir MK, Garcia ME, Jonsson PV, Peila R, Eiriksdottir G, et al. Cognitive impairment: an increasingly important complication of type 2 diabetes: the age, gene/environment susceptibility–Reykjavik study. Am J Epidemiol. 2008;168(10):1132-9.
Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
Kant R, Yadav P, Barnwal S, Dhiman V, Abraham B, Gawande K. Prevalence and predictors of depression in type 2 diabetes mellitus. J Edu Health Promot. 2021;10:23-9.
Allen KV, Frier BM, Strachan MW. The relationship between type 2 diabetes and cognitive dysfunction: longitudinal studies and their methodological limitations. Eur J Pharmacol. 2004; 490(1-3):169-75.
Ryan CM, Freed MI, Rood JA, Cobitz AR, Waterhouse BR, Strachan MW. Improving metabolic control leads to better working memory in adults with type 2 diabetes. Diab Care. 2006; 29(2):345-51.
Bruce DG, Casey GP, Grange V, Clarnette RC, Almeida OP, Foster JK, Ives FJ, Davis TM. Cognitive impairment, physical disability and depressive symptoms in older diabetic patients: the Fremantle Cognition in Diabetes Study. Diabetes research and clinical practice. 2003 Jul 1;61(1):59-67.
Zilliox LA, Chadrasekaran K, Kwan JY, Russell JW. Diabetes and cognitive impairment. Curr Diab Rep. 2016;16(9):1-1.
Ho SC, Woo J, Sham A, Chan SG, Yu AL. A 3-year follow-up study of social, lifestyle and health predictors of cognitive impairment in a Chinese older cohort. Int J Epidemiol. 2001;30(6):1389-96.
Irvine K, Laws KR, Gale TM, Kondel TK. Greater cognitive deterioration in women than men with Alzheimer's disease: a meta analysis. J Clin Exper Neuropsychol. 2012;34(9):989-98.
Yu ES, Liu WT, Levy P, Zhang MY, Katzman R, Lung CT, et al. Cognitive impairment among elderly adults in Shanghai, China. J Gerontol. 1989; 44(3):S97-106.
Elias PK, Elias MF, D'Agostino RB, Cupples LA, Wilson PW, Silbershatz H, et al. NIDDM and blood pressure as risk factors for poor cognitive performance: the Framingham Study. Diab Care. 1997;20(9):1388-95.
Gottesman RF, Rawlings AM, Sharrett AR, Albert M, Alonso A, Bandeen-Roche K, et al. Impact of differential attrition on the association of education with cognitive change over 20 years of follow-up: the ARIC neurocognitive study. Am J Epidemiol. 2014;179(8):956-66.
Abbott MA, Wells DG, Fallon JR. The insulin receptor tyrosine kinase substrate p58/53 and the insulin receptor are components of CNS synapses. J Neurosci. 1999;19(17):7300-8.
