Kidney Function and Risk of Physical and Cognitive Impairment in Older Persons with Type 2 Diabetes at an Outpatient Clinic with Geriatric Assessment Implementation

Aims: To determine whether there is an excess of cognitive impairment in patients with type 2 diabetes and foot ulceration. Methods: 55 patients with type 2 diabetes and foot ulcers attending Multidisciplinary Diabetes Foot Ulcer clinics (MDFU cohort) were compared with 56 patients with type 2 diabetes attending Complex Diabetes clinics (CDC cohort) using commonly used screening tests for cognitive impairment (Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA)), as well as foot self-care, mood and health literacy. MMSE was also compared between the MDFU cohort and a historical community-based cohort of patients with type 2 diabetes (FDS2 cohort). Results: Median MMSE scores were the same in all three groups (28/30). Median MOCA scores did not differ between the MDFU and CDC cohorts (25/30). There were no significant differences in the percentages of patients with MMSE ≤ 24 or MOCA ≤ 25 between MDFU and CDC cohorts (3.6% versus 10.7%, p = 0.27 and 56.4% versus 51.8%, p = 0.71, respectively), findings that did not change after adjustment for age, sex, education, diabetes duration, and random blood glucose. Conclusions: Using conventionally applied instruments, patients with type 2 diabetes and foot ulceration have similar cognition compared with patients without, from either hospital-based clinic or community settings.

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Feature Classification Method of Resting-State EEG Signals From Amnestic Mild Cognitive Impairment With Type 2 Diabetes Mellitus Based on Multi-View Convolutional Neural Network

IEEE Transactions on Neural Systems and Rehabilitation Engineering ◽

10.1109/tnsre.2020.3004462 ◽

2020 ◽

Vol 28 (8) ◽

pp. 1702-1709 ◽

Cited By ~ 1

Author(s):

Dong Wen ◽

Peng Li ◽

Yanhong Zhou ◽

Yanbo Sun ◽

Jian Xu ◽

...

Keyword(s):

Neural Network ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Resting State ◽

Amnestic Mild Cognitive Impairment ◽

Eeg Signals

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Effect of Advanced Glycation End Products on Cognition in Older Adults with Type 2 Diabetes: Results from a Pilot Clinical Trial

Journal of Alzheimer s Disease ◽

10.3233/jad-210131 ◽

2021 ◽

pp. 1-11

Author(s):

Roni Lotan ◽

Ithamar Ganmore ◽

Abigail Livny ◽

Nofar Itzhaki ◽

Mark Waserman ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Pilot Trial ◽

Advanced Glycation ◽

Glycation End Products ◽

End Products ◽

Global Cognition

Background: Dietary advanced glycation end-products (AGEs) are linked to cognitive decline. However, clinical trials have not tested the effect of AGEs on cognition in older adults. Objective: The aim of the current pilot trial was to examine the feasibility of an intervention to reduce dietary AGEs on cognition and on cerebral blood flow (CBF). Methods: The design is a pilot randomized controlled trial of dietary AGEs reduction in older adults with type 2 diabetes. Seventy-five participants were randomized to two arms. The control arm received standard of care (SOC) guidelines for good glycemic control; the intervention arm, in addition to SOC guidelines, were instructed to reduce their dietary AGEs intake. Global cognition and CBF were assessed at baseline and after 6 months of intervention. Results: At baseline, we found a reverse association between AGEs and cognitive functioning, possibly reflecting the long-term toxicity of AGEs on the brain. There was a significant improvement in global cognition at 6 months in both the intervention and SOC groups which was more prominent in participants with mild cognitive impairment. We also found that at baseline, higher AGEs were associated with increased CBF in the left inferior parietal cortex; however, 6 months of the AGEs lowering intervention did not affect CBF levels, despite lowering AGEs exposure in blood. Conclusion: The current pilot trial focused on the feasibility and methodology of intervening through diet to reduce AGEs in older adults with type 2 diabetes. Our results suggest that participants with mild cognitive impairment may benefit from an intensive dietary intervention.

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