Cognitive impairment among the patients with diabetes mellitus

Abstract

Cognitive impairment in Type 2 Diabetes Mellitus (T2DM) is a major public health problem that is mediated by insulin resistance, vascular damage and prolonged hyperglycemia. Adverse effects cognitive domains such as memory, attention, executive function and quality of life, as is also common with T2DM population. The objective of this study was to determine the prevalence and severity of cognitive impairment in T2DM patients by cross sectional study, carried out in BIRDEM and affiliated health care facilities in Dhaka. A purposive sample of 130 participants aged 36-75 years with T2DM for over 1 year were assessed using Mini Mental State Examination (MMSE) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). According to IQCODE, 26.2% of participants had normal cognition, 37.7% had slight cognitive decline, 29.2% had moderate decline, and 6.9% had severe impairment. Results of MMSE showed that 50.8% of participants had no cognitive impairment, 47.7% had mild cognitive decline and 1.5% had definite cognitive decline. Female subjects were more likely to show cognitive impairment, 46.8 percent of females having slight cognitive decline and 40.4 percent moderate cognitive decline, whereas 32.5 percent of males had slight cognitive decline and 22.9 percent had moderate cognitive decline. The prevalence of severe impairment was highest in participants aged 66-75 years (18.8%). Greater cognitive decline was strongly associated with uncontrolled diabetes (moderate, 31.9%; severe, 9.6%) and longer diabetes duration showed a progressive association with increasing severity of impairment. These results highlight the need for inclusion of standardized cognitive assessments and personalized interventions, such as effective glycemic control, lifestyle modifications for these patients to attenuate cognitive decline and improve clinical management. Keywords: Diabetes Mellitus (T2DM), Cognition, MMSE, IQCODE, Glycemic Control, Cognitive Impairment