Screening for Cognitive Disorders in Elderly Diabetics

2017 ◽  
Vol 41 (S1) ◽  
pp. S673-S673
Author(s):  
I. Baat ◽  
I. Abida ◽  
S. Omri ◽  
S. Ellouze ◽  
F. Hadj Kacem ◽  
...  

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 score was 20.68 ± 6. Forty patients (57%) had cognitive decline. The cognitive impairment was statistically correlated with female sex (P = 0.02), low level of education (P = 0.00), high levels of glycated hemoglobin (Hb A1c ≥ 7%) (P = 0.00), presence of hypoglycemic episodes (P = 0.05) and presence of dyslipidemia (P = 0.00).ConclusionOur study confirmed the high rate of cognitive decline in older type 2 diabetes patients. The profile of subjects at risk was consistent with the literature: poorly controlled diabetes, severe recurrent hypoglycaemia and associated dyslipidemia. Acting on these risk factors would prevent cognitive decline and therefore progression to dementia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Author(s):  
SARASWATI PRADIPTA ◽  
HERI WIBOWO ◽  
DANTE SAKSONO HARBUWONO ◽  
EKOWATI RAHAJENG ◽  
RAHMA AYU LARASATI ◽  
...  

Objective: Type 2 diabetes mellitus (T2DM) patients tend to have abnormal lipid profiles, explaining the association between elevated cholesterol andtriglyceride levels in diabetic patients and coronary heart disease. This study aims to evaluate how the common risk factors for dyslipidemia affectthe lipid profile of diabetic patients and to determine which factors can be used as predictors for the occurrence of dyslipidemia in T2DM patients.Methods: A total of 238 diabetic patients (63 male and 175 female; age: 31–70 years) were enrolled in this cross-sectional study. All of them hadundergone regular examinations in cohort studies on risk factors for non-communicable diseases conducted by the Ministry of Health in Bogorbetween December 2017 and January 2018.Results: The result found that age differences did not affect lipid profile levels, and the females had higher mean values of body mass index (p<0.001),total cholesterol (TC) (p<0.05), and high-density lipoprotein (HDL) (p<0.001) than the males. The most common occurrences of dyslipidemia werehigh TC level (57.1%), followed by high low-density lipoprotein (LDL) level (47.1%), high triglyceride level (37.4%), and low HDL level (16.4%). Beingoverweight was found to be the best predictor of dyslipidemia.Conclusion: The results of this study suggest that in T2DM patients, sex affects TC and HDL levels, whereas age does not exert a significant effect onthe lipid profiles. In addition, poor glycemic control, hypertension, and obesity may serve as predictors of dyslipidemia in T2DM patients.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Pereira ◽  
M Mendonca ◽  
J Monteiro ◽  
J Sousa ◽  
F Mendonca ◽  
...  

Abstract Type 2 Diabetes (T2D) is a risk factor for dysregulation of glomerular filtration rate (GFR) and albuminuria. However, it remains unclear whether this association is only causal. Genetic variants are inherited independent of potential confounding factors and represent a lifetime exposure. Aim Investigate whether the reduction of GFR is a direct consequence of T2D or there are other genetic mechanisms involved in the pathophysiology of the evolution to chronic kidney disease. Methods Cross-sectional study with a total of 2579 individuals was performed, of which 735 patients had T2D. Subjects were classified as `'diabetic” if they were taking oral anti-diabetic medication or insulin or if their fasting plasma glucose was higher than 7.0 mmol/l or 126 mg/dl. Within the diabetic group, we considered those with (n=63) and without (n=627) decreased GFR. GFR was calculated through the Cockcroft and Gault formula and decreased GFR was defined as GFR<60 ml/min/1.73m2. Twenty-four genetic variants associated with T2D, metabolic syndrome, dyslipidemia and hypertension were investigated for its impact on GFR, namely: MTHFR 677 and 1298; MTHFD1L; PON 55, 192 and 108; ATIR A/C; AGT M235T; ACE I/D; TCF7L2; SLC30A8; MC4R; ADIPOQ; FTO; TAS2R50; HNF4A; IGF2BP2; PPARG; PCSK9; KIF6; ZNF259; LPA; APOE; PSRS1. Risk factors for decreased GFR were also evaluated (essential hypertension, glycaemia >120 mg/ml, dyslipidemia, alcohol consumption, CAD diagnosis). A logistic regression was performed firstly with the risk factors solely; and secondly adding the genetic variants in order to evaluate the independent predictors of progression to renal failure in T2D. Results After the first multivariate logistic regression with all the risk factors for decreased GFR, only CAD remained in the equation, showing to be an independent risk factor for progression to renal failure, in T2D (OR=4.17; 95% CI: 1.64–10.59; p=0.003). In the second logistic regression, including risk factors and the genetic variants, only ZNF259 rs964184 showed an independent and significant association with the risk of decreased GFR (OR=3.03; 95% CI: 1.06–8.70; p=0.039). Conclusion This study shows that the variant ZNF259 rs964184 is associated with decreased kidney function, independently of other risk factors. This finding needs further investigation to clarify the genetic mechanism behind the association of rs964184 with decreased GFR, in Type 2 diabetes.


Author(s):  
Garima Sharma ◽  
Arti Parihar ◽  
Tanay Talaiya ◽  
Kirti Dubey ◽  
Bhagyesh Porwal ◽  
...  

AbstractMild cognitive impairment (MCI) is a modifiable risk factor in progression of several diseases including dementia and type 2 diabetes. If cognitive impairments are not reversed at an early stage of appearance of symptoms, then the prolonged pathogenesis can lead to dementia and Alzheimer’s disease (AD). Therefore, it is necessary to detect the risk factors and mechanism of prevention of cognitive dysfunction at an early stage of disease. Poor lifestyle, age, hyperglycemia, hypercholesterolemia, and inflammation are some of the major risk factors that contribute to cognitive and memory impairments in diabetic patients. Mild cognitive impairment was seen in those individuals of type 2 diabetes, who are on an unhealthy diet. Physical inactivity, frequent alcohol consumptions, and use of packed food products that provides an excess of cheap calories are found associated with cognitive impairment and depression in diabetic patients. Omega fatty acids (FAs) and polyphenol-rich foods, especially flavonoids, can reduce the bad effects of an unhealthy lifestyle; therefore, the consumption of omega FAs and flavonoids may be beneficial in maintaining normal cognitive function. These functional foods may improve cognitive functions by targeting many enzymes and molecules in cells chiefly through their anti-inflammatory, antioxidant, or signaling actions. Here, we provide the current concepts on the risk factors of cognitive impairments in type 2 diabetes and the mechanism of prevention, using omega FAs and bioactive compounds obtained from fruits and vegetables. The knowledge derived from such studies may assist physicians in managing the health care of patients with cognitive difficulties.


2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Debrah Asiimwe ◽  
Godfrey O. Mauti ◽  
Ritah Kiconco

Background. Type 2 diabetes is a worldwide disaster including in Uganda, specifically in Kanungu District which had a rise in diabetic patients in 2018/2019 as compared to the 2017/2018 financial year. This research was determined to access the prevalence and risk factors associated with type 2 diabetes on elderly patients aged 45-80 years attending Kanungu Health Centre IV, Kanungu District. Methods. A cross-sectional study was conducted among patients aged 45-80 years attending Kanungu Health Centre IV from June to August 2019. The prevalence of type 2 diabetes was determined by the blood sugar of patients. Questionnaires were used to collect data for factors associated with type 2 diabetes. Data were statistically analyzed using the statistical package for social sciences (SPSS) version 25 (SPSS Inc., USA) at P<0.05. Results. The overall prevalence of type 2 diabetes was 18.7% among the tested patients. 22.8% of diabetic patients were females as 7.8% were males. The age group most affected by diabetes was 61-65 years. Alcoholism, smoking, body mass index (BMI), and family history were found to be significantly associated with type 2 diabetes at P value < 0.05. Conclusion. There was a high prevalence of type 2 diabetes observed in this study compared to studies done in previous years which raise a public health concern. This study also found that females and patients aged 61-65 years were most affected by diabetes. Lastly, the presence of family history for diabetes, overweight, and being obese increases the chances of acquiring type 2 diabetes.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Khalid Al-Rubeaan ◽  
Fawaz Al-Hussain ◽  
Amira M. Youssef ◽  
Shazia N. Subhani ◽  
Ahmad H. Al-Sharqawi ◽  
...  

The main aim of this study is to determine the prevalence and risk factors of ischemic stroke among diabetic patients registered in the Saudi National Diabetes Registry (SNDR) database. A cross-sectional sample of 62,681 diabetic patients aged ≥25 years was used to calculate ischemic stroke prevalence and its risk factors. Univariate and multivariate logistic regression analyses were used to assess the roles of different risk factors. The prevalence of ischemic stroke was 4.42% and was higher in the older age group with longer diabetes duration. Poor glycemic control and the presence of chronic diabetes complications were associated with a high risk of ischemic stroke. History of smoking and type 2 diabetes were more frequent among stroke patients. Obesity significantly decreased the risk for ischemic stroke. Regression analysis for ischemic stroke risk factors proved that age ≥45 years, male gender, hypertension, coronary artery disease (CAD), diabetes duration ≥10 years, insulin use, and hyperlipidemia were significant independent risk factors for ischemic stroke. We conclude that ischemic stroke is prevalent among diabetic individuals, particularly among those with type 2 diabetes. Good glycemic, hypertension, and hyperlipidemia control, in addition to smoking cessation, are the cornerstones to achieve a significant reduction in ischemic stroke risk.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
N H Elshamy ◽  
I I Salama ◽  
M S Gabal ◽  
A M Hassan ◽  
G A Abdellatif

Abstract Objective The incidence of mild cognitive impairment increases with age, so this study is conducted to assess the relation between mild cognitive impairment and type 2 diabetes. Methods 100 type 2 diabetic patients attending Zagazig University outpatient clinics with age range from 40-60 years old was included in the study. These patients were matched with 100 non-diabetic controls regarding age, sex and educational class. Patients with important risk factors for cognitive disorders (cerebro-vascular stroke, organ failure, mental disorders, etc.) were not included in the study. Montreal cognitive assessment (MoCA) was done for all participants by an expert examiner using MoCA tool. Results Mild cognitive impairment was confirmed in 22% of diabetic patients and in 9% of control group (p &lt; 0.05) with total MoCA score lower in diabetic group than control one (p &lt; 0.01). Conclusion Type 2 diabetes may be associated with lower levels of cognitive function.


Author(s):  
Santisith Khiewkhern ◽  
Witaya Yoosook ◽  
Wisit Thongkum ◽  
Chitkamon Srichompoo ◽  
Sawan Thitisutti

Introduction: Diabetic Nephropathy (DN) is one of the most serious long-term complications of patients with type 2 diabetes and the leading cause of end-stage kidney failure. Early detection and risk reduction measures can prevent DN. However, data showing the survival time and factors associated with DN development among Thai patients with type 2 diabetes is currently not available. Aim: This study aims to explore the survival time and examine the risk factors associated with the development of DN among Thai patients with type 2 diabetes. Materials and Methods: This cross-sectional retrospective study was conducted during 1st January, 2002 to 3rd December, 2017 to performed and to explore the survival time and examine the risk factors associated with the development of DN among 1,540 patients with type 2 diabetes who received treatment at the Diabetes Mellitus (DM) clinic in Mahachanachai Hospital, Yasothon Province, Thailand. Data was collected from the Hospital Experience (HOSxP) program and medical records from 2002 to 2017. Kaplan-Meier and Cox’s regressions were used for data analysis. Results: From those 15 years, out of 1,540 cases 306 eligible patients with type 2 DM were selected for survival analysis. The results showed that 274 patients met the criteria for DN (89.50%) and 32 patients (10.50%) did not meet the criteria for DN. The median of DN survival time was five years. Multivariate Cox’s regression analysis confirmed that systolic blood pressure had a statistically significant association with the development of DN among hospitalised type 2 diabetic patients. Conclusion: Duration of Diabetes and Systolic blood pressure are associated with the development of DN. The application of future prevention and control measures are highly recommended to control systolic blood pressure for DN protection.


VASA ◽  
2002 ◽  
Vol 31 (4) ◽  
pp. 249-254 ◽  
Author(s):  
Zander ◽  
Heinke ◽  
Reindel ◽  
Kohnert ◽  
Kairies ◽  
...  

Background : Diabetic patients have increased prevalence of peripheral arterial disease (PAD). It is not clearly shown whether the prognostic factors are identical in relation to the type of diabetes. This study was done to compare the associations of PAD with risk factors and with micro-and macrovascular complications of inpatients with type 1 and type 2 diabetes. Methods: In a retrospective cross-sectional study 1087 patients with type 1 diabetes and 1060 patients with type 2 diabetes were examined. PAD was diagnosed when ankle-brachial-pressure-index (ABI) was < 1.0. In cases with incompressible arteries (mediasclerosis) pulse wave formes were analyzed. Multivariate logistic regression analysis was applied to evaluate the impact of different variables on PAD risk , after adjusting for different variables separately. Results: In both types of diabetes (type 1 vs. type 2) PAD risk (odds ratio; OR) was increased in the presence of coronary heart disease (OR 9.3 vs. 3.5), diabetic nephropathy (OR 3.0 vs.2.8), neuropathy (OR 7.9 vs. 1.8), foot ulceration (OR 8.9 vs. 5.5), increased daily insulin requirement > 0.6 m/kg b.w. (OR 5.2 vs. 2.9), diabetes duration of 20–29 years (OR 28.9) and > 30 years (OR 51.1) in type 1 diabetes, and diabetes duration of 10–19 years (OR 3.8) and > 20 years (OR 4.3) in type 2 diabetes. In type 2 diabetes, PAD risk was associated with microalbuminuria (OR 2.1), macroalbuminuria (OR 3.3), background retinopathy (OR 1.9), proliferative retinopathy (OR 2.8), increased triglycerides (TG) (OR 1.7) and decreased HDL-cholesterol (HDL-C > 0.90 mmol/l: OR 0.49). Conclusions: PAD risk factors and micro- and macrovascular comorbidity are very similar in type 1 and type 2 diabetes.


2017 ◽  
pp. 35-44
Author(s):  
Dinh Toan Nguyen

Background: Studies show that diabetes mellitus is the greatest lifestyle risk factor for dementia. Appropriate management and treatment of type 2 diabetes mellitus could prevent the onset and progression of mild cognitive impairment to dementia. MoCA test is high sensitivity with mild dementia but it have not been used and studied widespread in Vietnam. Aim: 1. Using MoCA and MMSE to diagnose dementia in patients with type 2 diabetes mellitus. 2. Assessment of the relationship between dementia and the risk factors. Methods: cross-sectional description in 102 patients with type 2 diabetes mellitus. The Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. The diagnosis of dementia was made according to Diagnostic and Statistical Manual of Mental Disorders. Results: The average value for MoCA in the group of patients with dementia (15.35 ± 2.69) compared with non-dementia group (20.72 ± 4.53). The sensitivity and specificity of MoCA were 84.8% and 78.3% in identifying individuals with dementia, and MMSE were 78.5% and 82.6%, respectively. Using DSMIV criteria as gold standard we found MoCA and MMSE were more similar for dementia cases (AUC 0.871 and 0.890). The concordance between MoCA and MMSE was moderate (kappa = 0.485). When considering the risk factors, the education,the age, HbA1c, dyslipidemia, Cholesterol total related with dementia in the type 2 diabetes. Conclusion: MoCA scale is a good screening test of dementia in patients with type 2 diabetes mellitus.When compared with the MMSE scale, MoCA scale is more sensitive in detecting dementia. Key words: MoCA, dementia, type 2 diabetes mellitus, risk factors


Sign in / Sign up

Export Citation Format

Share Document