Factors Associated with Mild Cognitive Impairment among Elderly Filipinos with Type 2 Diabetes Mellitus

Abstract

Objectives. This study aims to identify factors associated with mild cognitive impairment (MCI) among elderly Filipinos with Type 2 diabetes mellitus.Methodology. This is an analytic cross-sectional study involving 133 elderly (≥60 years old) with Type 2 diabetes mellitus consecutively sampled from the General Medicine and Diabetes Clinics of the Philippine General Hospital. Eligible subjects were interviewed to gather demographic and clinical data. Body mass index, waist-hip ratio and mean blood pressure were computed. HBA1c, lipid profile, creatinine and urine proteinuria were tested or recorded if done recently. Dilated fundus examination via indirect ophthalmoscopy and 10-gram monofilament test were performed to detect retinopathy and neuropathy. The Montreal Cognitive Assessment-Philippines tool was administered to detect patients with probable MCI using a cutoff score of ≤21. Multivariate logistic regression analysis was performed to determine the associated factors.Results. Using MoCA-P tool, MCI has a rate of 45% among elderly Filipino diabetics. Having more than 12 years of education is significantly associated with lower odds of MCI. (OR 0.38 CI 0.18, 0.80, p value 0.010).Conclusion. The rate of MCI among Filipino elderly diabetics is high. Higher education is associated with lower odds of having MCI. Case-control or prospective cohort studies involving larger sample and non-diabetic population are recommended.

Predictors of Cognitive Impairment among Filipino Patients with Type 2 Diabetes Mellitus in a Tertiary Government Hospital

“…Blood glucose abnormalities and insulin resistance were reported to be linked to cognitive impairment in patients with T2DM. 7,8,10 In comparison to a study done by Blanquisco et al 11 , low educational attainment was not a predictor of cognitive impairment. Smoking and lipid profile were comparable to both patients with normal cognition and cognitive impairment.…”

“…The prevalence was lower in contrast to the study of Blanquisco et al which only included Filipino patients more than 60 years old. 11 This study noted that 69.6% of the cognitively impaired patients were less than 65 years old (Table 1).…”

Diabetes, Albuminuria and the Kidney—Brain Axis

“…A cross-sectional study conducted in a Filipino population with an average 12-year T2D duration observed a higher rate of mild cognitive impairment (45%) than previous studies among Korean and Polish populations, which described lower prevalences (31.5% and 32.7%, respectively) [ 26 ]. Furthermore, patients in the Filipino study reported poor results in language and recall, in contrast with previous studies that observed a decline in executive functions [ 37 , 38 , 39 ].…”

“…Additionally, there is wide variability across the studies in the cognitive assessments ( Table 1 ), ranging from studies using simple screening tests to studies using neuropsychological batteries exploring several cognitive domains. In this regard, some studies have found a close relation between albuminuria and memory [ 11 , 14 , 16 , 25 , 26 , 31 ]. However, others have not found a close relation but, instead, have found associations with the processing speed or executive functions.…”

“…Moreover, a recent meta-analysis provided the same conclusions [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ] based on the results of population-based studies. Less is known about T2D specifically; however, because T2D patients suffer from both an increased risk of cognitive impairment and kidney disease [ 22 , 23 , 24 , 25 , 26 , 27 , 28 ], elucidating the mechanisms of disease and exploring the interplay between the brain and kidney might potentially help to prevent cognitive impairment both in general and T2D populations.…”