Assessment of cognitive functions in middle-aged patients with type 2 diabetes
DOI:
https://doi.org/10.18370/2309-4117.2022.65.113-117Keywords:
type 2 diabetes mellitus, cognitive dysfunction, testing, early detection, obesity, comorbid pathologyAbstract
Objectives: to evaluate cognitive functions in middle-aged patients with type 2 diabetes mellitus (T2DM).
Materials and methods. The total number of participants was 72 people. The main group included 52 patients with T2DM (25 women, 27 men), the control group included 20 people (11 women, 9 men) without T2DM and without carbohydrate metabolism disorders.
Cognitive function was assessed using the following scales: the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Anxiety-depressive disorders were assessed using self-administered questionnaires: the Hospital Anxiety and Depression Scale (HADS) and the Beck’s Depression Inventory scale.
Results. In the main group the average duration of T2DM was 8.31 ± 0.53 years, the average HbA1c level was 8.14 ± 0.07%, the fasting glycemia level was 7.07 ± 0.11 mmol/l, average body mass index (BMI) – 28.45 ± 0.60 kg/m2. 18 patients in this group had a normal body weight with an average BMI 23.58 ± 0.26 kg/m2, 12 people had an excessive body weight with an average BMI 28.21 ± 0.43 kg/m2, 22 patients had obesity of various severities with an average BMI 32.57 ± 0.51 kg/m2. The following results were obtained in patients with T2DM according to the MMSE scale: 54% (n = 28) of patients had no cognitive impairment (CI), 46% (n = 24) had various degrees of СІ, of which 27% (n = 14) had mild degree CI, 19% (n = 10) had moderate severity CI. According to the MoCA scale, cognitive deficit was found in 44% of the participants of the main group. According to the Beck’s scale, the following data were obtained: 10 (20%) people had no signs of depression, 34 (65%) of the respondents had signs of subclinical depression, 3 (15%) had signs of clinically expressed depression.
Conclusions. We established a direct, close relationship between BMI and HbA1c level according to Spearman’s rank correlation coefficient (ρ = 0.730). When CI is detected, the doctor should review the treatment plan for such patients, avoiding complex management plans that overload patients physically, emotionally, or financially, and will not be implemented to the required extent due to cognitive deficits.
References
- International Diabetes Federation. IDF Diabetes Atlas, 10th ed, issue 2021. Available from: [http://www.diabetesatlas.org], last accessed 30 April 2022.
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-V. 5th ed. Washington (2013).
- Saedi, E., Gheini, M.R., Faiz, F., Arami, M.A. “Diabetes mellitus and cognitive impairments.” World J Diabetes 7.17 (2016): 412–22. DOI: 10.4239/wjd.v7.i17.412
- Mallorquí-Bagué, N., Lozano-Madrid, M., Toledo, E., et al. “Type 2 diabetes and cognitive impairment in an older population with overweight or obesity and metabolic syndrome: baseline cross-sectional analysis of the PREDIMED-plus study.” Sci Rep 8 (2018): 16128. DOI: 10.1038/s41598-018-33843-8
- Lee, H.J., Seo, H.I., Cha, H.Y., et al. “Diabetes and Alzheimer’s disease: mechanisms and nutritional aspects.” Clin Nutr Res 7 (2018): 229–40. DOI: 10.7762/cnr.2018.7.4.229
- Roberts, R.O., Geda, Y.E., Knopman, D.S., et al. “Association of duration and severity of diabetes mellitus with mild cognitive impairment.” Arch Neurol 65.8 (2008): 1066–73. DOI: 10.1001/archneur.65.8.1066
- Biessels, G.J., Whitmer, R.A. “Cognitive dysfunction in diabetes: how to implement emerging guidelines.” Diabetologia 63.1 (2020): 3–9. DOI: 10.1007/s00125-019-04977-9
- Cholerton, B., Baker, L.D., Montine, T.J., Craft, S. “Type 2 Diabetes, Cognition, and Dementia in Older Adults: Toward a Precision Health Approach.” Diabetes Spectr 29.4 (2016): 210–9. DOI: 10.2337/ds16-0041
- World Health Organization. Dementia. Fact sheets (2021). Available from: [https://www.who.int/en/news-room/fact-sheets/detail/dementia].
- Zhao, Q., Roberts, R.O., Ding, D., et al. “Diabetes is Associated with Worse Executive Function in Both Eastern and Western Populations: Shanghai Aging Study and Mayo Clinic Study of Aging.” J Alzheimers Dis 47.1 (2015): 167–76. DOI: 10.3233/JAD-150073
- Cukierman-Yaffe, T., Gerstein, H.C., Williamson, J.D., et al. “Relationship between baseline glycemic control and cognitive function in individuals with type 2 diabetes and other cardiovascular risk factors: the action to control cardiovascular risk in diabetes-memory in diabetes (ACCORD-MIND) trial.” Diabetes Care 32.2 (2009): 221–6. DOI: 10.2337/dc08-1153
- Lee, H.J., Seo, H.I., Cha, H.Y., et al. “Diabetes and Alzheimer’s disease: mechanisms and nutritional aspects.” Clin Nutr Res 7 (2018): 229–40. DOI: 10.7762/cnr.2018.7.4.229
- Launer, L.J., Miller, M.E., Williamson, J.D., et al. “Effects of intensive glucose lowering on brain structure and function in people with type 2 diabetes (ACCORD MIND): a randomised open-label substudy.” Lancet Neurol 10.11 (2011): 969–77. DOI: 10.1016/S1474-4422(11)70188-0
- Areosa Sastre, A., Vernooij, R.W., González-Colaço Harmand, M., Martínez, G. “Effect of the treatment of Type 2 diabetes mellitus on the development of cognitive impairment and dementia.” Cochrane Database Syst Rev 6.6 (2017): CD003804. DOI: 10.1002/14651858.CD003804.pub2
- Zherdyova, N.M. “Cognitive disorders in elderly patients with type 2 diabetes.” Public Health 6.1–2 (2017): 49–52.
- Tomlin, A., Sinclair, A. “The influence of cognition on self-management of type 2 diabetes in older people.” Psychol Res Behav Manag 9 (2016): 7–20. DOI: 10.2147/PRBM.S36238
- Cuevas, H.E., Stuifbergen, A.K., Brown, S.A., Rock, J.L. “Thinking About Cognitive Function: Perceptions of Cognitive Changes in People With Type 2 Diabetes.” The Diabetes Educator 43.5 (2017): 486–94. DOI: 10.1177/0145721717729806
- Munshi, M.N. “Cognitive Dysfunction in Older Adults With Diabetes: What a Clinician Needs to Know.” Diabetes Care 40.4 (2017): 461–7. DOI: 10.2337/dc16-1229
- Feinkohl, I., Price, J.F., Strachan, M.W., Frier, B.M. “The impact of diabetes on cognitive decline: potential vascular, metabolic, and psychosocial risk factors.” Alzheimer’s Res Ther 7.1 (2015): 46. DOI: 10.1186/s13195-015-0130-5
- Sharma, G., Parihar, A., Talaiya, T., et al. “Cognitive impairments in type 2 diabetes, risk factors and preventive strategies.” J Basic Clin Physiol Pharmacol 31.2 (2020): 20190105. DOI: 10.1515/jbcpp-2019-0105
- Yang, H., Yim, D., Park, M.H. “Converting from the Montreal Cognitive Assessment to the Mini-Mental State Examination-2.” PloS One 16.7 (2021): e0254055. DOI: 10.1371/journal.pone.0254055
- Myrberg, K., Hydén, L.-C., Samuelsson, C. “Instances of trouble in aphasia and dementia: an analysis of trouble domain and interactional consequences.” Aphasiology (2021): 1–18. DOI: 10.1080/02687038.2021.1959515
- Scarabelot, L.F., Monteiro, M.M., Rubert, M., Zetola, V. “Is the Mini-Mental State Examination the best cognitive screening test for less educated people?” Arq Neuropsiquiatr 77.5 (2019): 330–4. DOI: 10.1590/0004-282X20190043
- Pugh, E.A., Kemp, E.C., van Dyck, C.H., et al. “Effects of Normative Adjustments to the Montreal Cognitive Assessment.” Am J Geriatric Psychiatry 26.12 (2018): 1258–67. DOI: 10.1016/j.jagp.2018.09.009
- Kang, J.M., Cho, Y.S., Park, S., et al. “Montreal cognitive assessment reflects cognitive reserve.” BMC Geriatrics 18.1 (2018): 261. DOI: 10.1186/s12877-018-0951-8
- Jia, X., Wang, Z., Huang, F., et al. “A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study.” BMC Psychiatry 21.1 (2021): 485. DOI: 10.1186/s12888-021-03495-6
- Stern, A.F. “The Hospital Anxiety and Depression Scale.” Occup Med 64.5 (2014): 393–4. DOI: 10.1093/occmed/kqu024
- Beekman, E., Verhagen, A. “Clinimetrics: Hospital Anxiety and Depression Scale.” J Physiother 64.3 (2018): 198. DOI: 10.1016/j.jphys.2018.04.003
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Copyright (c) 2022 В.І. Величко, В.Л. Михайленко, Є.О. Тулянцева, Д.О. Лагода, Г.О. Данильчук, Ю.Г. Циунчик
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