Cognitive Impairment and Associated Factors among Older Adults with Diabetes in a Suburban Primary Health Center in Thailand

Abstract

<b><i>Introduction:</i></b> Thailand is a rapidly aging society. The percentage of older adults with diabetes has also been increasing. Since diabetes mellitus is documented as a risk factor for dementia, it is important to address cognitive impairment in older adults with diabetes. Thus, this study aimed to evaluate the prevalence and associated factors of cognitive impairment among older adults with diabetes in a suburban primary health center in Thailand. <b><i>Methods:</i></b> A cross-sectional study in 244 diabetic patients aged 60 years or older was conducted in a primary health care unit in Pathum Thani, Thailand. Cognitive function was assessed with the validated Thai version of the Mini-Addenbrooke’s Cognitive Examination Test. Sociodemographic and health characteristic data were obtained. <b><i>Results:</i></b> The prevalence of cognitive impairment was 54.5% (133 out of 244). Multivariate logistic regression disclosed that factors significantly associated with cognitive impairment were ages 70–79 years compared to ages 60–69 years (odds ratio [OR] 1.90, 95% confidence interval [CI]: 1.01–3.62, <i>p</i> value 0.048), ages ≥80 years compared to ages 60–69 years (OR 3.65, 95% CI: 1.19–11.24, <i>p</i> value 0.024), education ≤ primary school (OR 7.28, 95% CI: 3.56–14.89, <i>p</i> value <0.001), and medication managed by caregiver compared to self-management of medication (OR 13.40, 95% CI: 1.55–116.10, <i>p</i> value 0.019). <b><i>Conclusion:</i></b> We revealed that approximately half of older adults with diabetes had cognitive impairment. This finding strongly suggests the need to include cognitive assessment in a standard clinical practice guideline for diabetic patients and to focus more on individuals who are very old, have low education, or are unable to manage their drugs by themselves.

Abstracts

“…Conclusions: Cognitive impairment was recognised less frequently than expected in older adults attending the diabetes clinic. Compared with the expected prevalence (between 29% and 74% [1][2][3][4]), this suggests a large pool of adults with unrecognised cognitive impairment. This presents a rich opportunity for quality improvement, and supports the case for routine screening for cognitive impairment amongst older adults attending the diabetes clinic.…”

“…A lower BMI was associated with increased transfers to ED and a higher MUST with readmission. 4 General Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia; 5 Emergency Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; 6 Geriatrics, Redcliffe Hospital, Redcliffe, Queensland, Australia Aim: To determine the incidence of acute intracranial haemorrhage on CT head imaging post fall in interim care patients and associated rates of neurosurgical intervention. Methods: A clinical audit of inpatient falls and utility of computer tomography (CT) brains at Brighton Interim Care was conducted.…”

“…Tessa O'Halloran 1,2 ; Rosie Watson 1,3,4 ; Mervyn Kyi Both an automated and manual search was undertaken to identify any record of cognitive impairment. Extracted data were analysed using simple descriptive statistics.…”