A comparative study for evaluation of cognitive function in type-II diabetes mellitus patients and non-diabetics
Keywords:Cognitive dysfunction, Standardized Mini Mental State Examination (SMMSE), Type-II diabetes mellitus
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 diabetics. The association of development of cognitive impairment and duration of diabetes mellitus was significant statistically (p value = 0.025443; p<0.05). Other demographic variables like gender, education and domicile were also seen to affect the results.
Conclusions: Mild to moderate cognitive impairment was found significantly higher among the type-II diabetics than the non-diabetics. The cognitive impairment was found to be associated with the duration of diabetes. Hence the routine screening of cognition by SMMSE should be done in all type-II diabetic patients.
Harsh Mohan. Textbook of Pathology. 6th Ed.: Jaypee Brothers Medical Publishers (P) Ltd; 2010:818.
Melmed S, Polonsky KS. Larsen PR, Kronenberg HM. William Textbook of Endocrinology. 12th Ed. Philadelphia: Elsevier/Saunders; 2011:1371-1435.
Smyth S, Heron A. Diabetes and Obesity: The twin epidemics. Nature Medicine; January 2006;12(1):75-80.
Iacobuzio-Donahue CA. The Endocrine Pancreas. Robins and Cotran’s pathologic basis of disease. 9th Ed. Philadelphia; Elsevier/Saunders; 2015:1105.
Goldstein BJ. Dirk Mueller-Wieland. Type-II diabetes: Principles and Practice. 2nd Ed. Crc Press.; 2007:7.
National Ageing Research Institute. Final Report: The Assessment of Older People with dementia and depression of Culturally and Linguistically Diverse Backgrounds: A review of current practice and the development of guidelines for Victorian Aged Care Assessment Services. Final Report, July 2011. Available at: https://www2.health.vic.gov.au/Api/downloadmedia/%7B506DB4FF-039F-4753-88E2-61F4E76448D6%7D. Accessed 18 June 2014.
Morris JC, Storandt M, Miller JP, McKeel DW Jr, Price JL, Rubin EH, and others. Mild cognitive impairment represents early-stage Alzheimer’s disease. Arch Neurology. 2001;58:397-405.
William Molloy D, MB, MRCPI, FRCPC1, Timothy IM Standish, Lewis DL, PhD_Can J. Screening for Mild Cognitive Impairment Psychiatry. January 2005;50(1).
Beeri MS, Goldbourt U, Silverman JM, Noy S, Schmeidler J, Ravona-Springer R, et al. Diabetes mellitus in midlife and the risk of dementia three decades later. Neurology. 2004 Nov 23;63(10):1902-7.
Kataria L, Pandya H, Shah S, Shah H, Gerg R. (India): Prevalence and pattern of cognitive dysfunction in type-II diabetes mellitus. International Journals of medical and applied sciences. ISSN:2320-3137.
Alencar RC. (Brazil). Assessment of cognitive status in patients with type -II diabetes mellitus through MMSE. Diabetology and Metabolic syndrome. 28 Jan 2010.
Smith GE, Bondi MW. Mild Cognitive Impairment and Dementia: Definitions, Diagnosis, and Treatment. AACN/Oxford Workshop Series; 2013:238.
Luchsinger JA. Type-II Diabetes and cognitive impairment linking mechanisms. PMC June 12, 2012.
Knut-Olaf H, Groneberg D. Tobacco or Health?: Physiological and social damages caused by tobacco smoking. 2nd Ed. Springer; 2010:160.
Harward MP, Udden MM. Medical Secrets. 5th Ed. Mosby Elsevier; 2011:544.
Prisant ML. Hypertension in the elderly. Humana Press; 2005:272.
Colditz GA, Manson JE, Hankinson SE: The Nurses’ Health Study: 20 year contribution to the understanding of health among women. J. Women’s Health. 1997;6:49-62.
Reaven GM, Thompson LW, Nuhan D, Haskins E. Relationship between hyperglycemia and cognitive function in older NIDDM patients. Diabetes care. 1990;13:16-21.