A simple screening test with a potential to detect diabetic cognitive impairment in the geriatric population: a preliminary study (original) (raw)
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COGNITIVE FUNCTION-A COMPARISON BETWEEN ELDERLY NON DIABETIC AND DIABETIC SUBJECTS
Introduction:- Increase in life expectancy and fall in death rate has led to rise in the proportion of the elderly in the community all over the world. The ageing population is facing a double epidemic of dementia including Alzheimer’s disease and diabetes mellitus. The increase in diabetes among elderly is concerning because, in addition to the traditional diabetes complications like acute hyperglycemic and hypoglycemic events and vascular complications, diabetes also affects the central nervous system, a complication referred to as ‘diabetic encephalopathy’, which presents as impaired cognitive functioning and is also associated with an increased risk of dementia. Hence this study was under taken to draw attention to the occurrence of cognitive impairment in type 2 diabetes mellitus, in our community, and thereby pave the way for future initiatives to reduce its incidence. Aim and objectives:- To compare the cognitive functions of elderly non-diabetic subjects with that of elderly type 2 diabetes mellitus subjects using standard neuropsychological tests and to correlate with their blood sugar and lipid levels. Materials and methods:- The study was conducted in 60 participants in the age group of 58-65 years. Of these the case group comprised of 30 individuals with type 2 diabetes mellitus and the control group was formed by age, gender and education matched non-diabetic individuals. Blood samples were collected from all participants. After a brief screening test the participants were asked to take the neuropsychological test battery for evaluating their cognitive status. Comparison of the raw test scores of the cases and controls was done using the student‘t’ test. Results and conclusion:- The diabetes group showed poorer performance in all the cognitive function tests than the non-diabetes group with no correlation between blood glucose and cholesterol levels and the neuropsychological test scores of the patients. Hence, it can be concluded that periodical assessment of cognitive functions in diabetes clinics would be helpful in early identification and management of cases with cognitive impairment, which in turn can reverse the cognitive decline and prevent the development of dementias in these patients.
Screening for cognitive disorders in elderly diabetics
European Psychiatry, 2017
IntroductionOld people with diabetes are more likely to develop cognitive impairment, Alzheimer's disease and vascular dementia. However, the determinants of the association between diabetes and cognitive impairments are only partially known.ObjectivesTo evaluate cognitive disorders in elderly diabetic patients and to identify risk factors of cognitive impairment in this population.MethodsIt was a cross-sectional study. It involved outpatients aged 65 and older, who were followed for diabetes in the endocrinology department at the Hedi Chaker University Hospital in Sfax (Tunisia), from October 1 to December 31, 2015. For each patient, we collected sociodemographic, clinical and therapeutic data. We used the Montreal Cognitive Assessment (MoCA) to identify mild cognitive decline (score < 26/30).ResultsWe identified 70 patients, all with type 2 diabetes. The average age was 66.8 years. The sex ratio (M: F) was 0.7. The mean duration of diabetes was 14.76 years. The average MoCA...
Evaluation of cognitive functions in diabetic patients
International Journal of Research in Medical Sciences
Background: Diabetes Mellitus is an independent risk factor for cognitive impairment and dementia. In this study, authors investigated cognitive functions in the diabetes and control group with Mini Mental State Examination (MMSE). Authors analyzed the association of cognitive status with age, sex, duration of diabetes, insulin use and HbA1c in diabetic patients.Methods: Fifty patients with diabetes diagnosed between the ages of 50 and 70 who applied to this Diabetes and General Internal Medicine Clinics between January 2017 and September 2017 were included. Fifty patients with nondiabetes diagnosed with similar age and demographic characteristics were included in the control group. MMSE was applied to both groups. In the diabetic group, cognitive functions were investigated in relation with age, gender, duration of diabetes, insulin usage and HbA1c.Results: The MMSE score in diabetic patients was lower than the control group (p<0.05). In addition, cognitive impairment in diabeti...
Diabetes as a Risk Factor for Cognitive Decline in Older Patients
Dementia and Geriatric Cognitive Disorders, 2008
To assess the role of type 2 diabetes as a risk factor for cognitive decline among elderly people. Methods: Analyses were carried out on data from the Italian Longitudinal Study on Aging, a study on 5,632 subjects aged 65-84 years, with baseline in 1992 and follow-ups in 1996 and 2000. Results: At baseline, diabetic women had significantly worse scores on all cognitive tests compared to nondiabetic women, but did not show worsening over time, whereas men with diabetes did not show worse scores on cognitive tests at baseline compared to nondiabetic males; however, diabetes in men was associated with a risk of cognitive decline over time, particularly in attention. Higher levels of HbA 1c were associated with poorer performance on memory tests at follow-up in both sexes. Conclusion: The impact of diabetes on cognitive status might differ in older men and women, probably because of a survival effect, with a higher mortality at a younger age among diabetic men. The metabolic and cardiovascular abnormalities associated with diabetes might be responsible for the cognitive decline, at different rates and ages, in men and women. The routine assessment of diabetes complications in the elderly should include cognitive evaluation in both sexes.
Diabetes Is Associated with Cognitive Decline in Middle-Aged Patients
Metabolic syndrome and related disorders, 2018
Diabetes is a major contributor to dementia in the elderly. Identifying mild cognitive decline in younger individuals with diabetes could aid in preventing the progression of the disease. The aim of our study is to compare whether patients with diabetes experience greater cognitive decline than those without diabetes. We conducted a cross-sectional study using population-based recruitment to identify a cohort of individuals with diabetes and corresponding control group without diabetes of 55-65 years of age. We defined diabetes according to the American Diabetes Association and conducted a battery of standardized neuropsychological tests consisting of nine verbal and nonverbal tasks assessing three cognitive domains. We defined cognitive decline as an abnormal test in one or more of the domains. We used hierarchical regression to predict abnormal cognitive function by diabetes status, adjusting for gender, education, hypertension, and depression. We included 142 patients with diabet...
Type 2 Diabetes Mellitus and Cognitive Function in the Elderly
Iranian Journal of Psychiatry and Behavioral Sciences, 2018
Background: Cognitive impairment is one of the complications experienced by older adults with diabetes. Objectives: This study was conducted to assess the association of cognitive function with the glycemic condition of the elderly population. Methods: This analytic cross-sectional study was conducted on individuals 60 years and over in Babol, Northern Iran, during 2014 and 2015. Sociodemographic characteristics, history of other chronic diseases, medications, physical examination, fasting blood glucose, and serum lipid profile were used for data collection. MMSE was used to assess cognitive function and GDS for depressive symptoms. Results: A total of 1,503 individuals participated in the study. The mean age of the participants was 69.07 ± 7.28 years; of them, 1,038 (69.1%) were normoglycemic (non-diabetic) and 465 had (31.9%) diabetes mellitus. There were significant differences in weight, BMI, systolic blood pressure, serum TG, LDL, and past medical history of MI or angina pectoris between diabetic and non-diabetic patients (P < 0.05). Of the elderly, 1,042 (69.3%) had normal cognition and 461 (30.7%) showed impaired cognition according to MMSE cut values. The mean of MMSE score in non-diabetic and diabetic patients was 25.51 ± 3.40 (25.30-25.72) and 25.02 ± 3.86 (24.63-25.46), respectively (P = 0.018). A significant difference was observed in the severity of cognitive impairment between the two groups (P = 0.048). Conclusions: Older adults with diabetes mellitus have poorer cognitive functions, therefore, health care providers and family physicians should pay more attention to the identification of any cognitive decline in the initial stages of diabetes mellitus.
International Journal of Basic & Clinical Pharmacology, 2018
Background: To evaluate the impact of type-II diabetes mellitus on cognitive function and to assess the factors associated with impaired function.Methods: This prospective study compared 100 type-II diabetic people attending the diabetic clinic of Tirunelveli Medical College Hospital with another 100 membered control group. The study group was selected randomly between the age group of 45-65 years. A neuro-cognitive assessment was done using Standardized Mini Mental State Examination (SMMSE), which is a simple and reliable screening test. This scale has 12 questions with time limits to assess orientation, memory, calculation, language, attention and construction. Magnitude and severity of cognitive decrement were analysed along with the possible factors affecting it.Results: Mean age of the study population was 54.6±7.24 years. Cognitive impairment was noted among 62 of cases and 48 of the control group, which means a 14% higher prevalence of cognitive impairment among the type 2 di...
Assessment of Cognitive Status in Type 2 Diabetes
International journal of collaborative research on internal medicine and public health, 2014
Introduction: The increasing prevalence of diabetes over the world has become an important public health problem. Diabetes is considered a non-communicable disease nowadays, with about 173 million diabetic people over the world. Generally, problems for the elderly are impaired activities of daily living (ADL) and cognitive dysfunction. Central nervous system involvement is increasingly recognized as a possible complication of diabetes. Cognitive impairment might be another factor associated with poor diabetes control and also with bad adherence of patients to educational approaches, such as diet orientations. Objective: To assess the cognitive impairment in type 2 diabetes. Methods: A cross sectional study was designed and patients were recruited from Abbasi Shaheed Hospital with a non-probability convenient sampling. Patients having type 2 diabetes over 30 years of age were included and patients with blindness, stroke and psychiatric disorders were excluded. Sample size was done by...
Diabetes and cognitive function in a population-based study of elderly women and men
Journal of Diabetes and its Complications, 2006
The aim of this study was to examine the association between diabetes and cognitive function in the elderly. From January to December 2003, all 740 participants, aged 70 years or more, of an ongoing population-based cohort study were eligible for a telephone interview on cognitive function. Cognitive function was assessed using validated instruments, including the Telephone Interview of Cognitive Status (TICS) and the East Boston Memory Test (EBMT). Information on diabetes was available from prior questionnaires and was validated in 2002. We used multivariable logistic regression to estimate odds ratios (OR) of an impaired cognitive function (below 25th percentile) and their 95% confidence intervals (CI) adjusting for age, gender, smoking, alcohol consumption, body mass index (BMI), physical exercise, educational level, and depressive symptoms. Out of 473 participants interviewed (64.9%), 66 had diabetes (14.1%). The adjusted OR for diabetes and impaired cognitive function assessed by TICS was 2.3 (95% CI: 1.2-4.3). Diabetes was also associated with performance on delayed recall EBMT (adjusted OR=2.0; 95% CI: 1.0-4.1), but not immediate EBMT recall (adjusted OR=1.0; 95% CI: 0.5-2.1). The association between diabetes and cognitive function was a bit more pronounced in participants in whom diabetes was diagnosed 12 (median) or more years prior (adjusted OR with TICS=2.4; 95% CI: 1.0-5.8) and in those without antidiabetic treatment (age- and sex-adjusted OR=3.4; 95% CI: 1.7-6.5). Diabetes should be considered to be a risk factor for cognitive impairment in the elderly, which might be attenuated by antidiabetic treatment.