Prevalence of Cognitive Decline in Type 2 Diabetes Mellitus Patients: A Real-World Cross-Sectional Study in Mysuru, India

Abstract

The goal of this research is to study the prevalence of cognitive impairment in diabetes mellitus (DM) patients and establish the necessity of detecting and treating it early in these patients. A cross-sectional study was conducted at a tertiary care hospital in Mysuru for 4 months examined diabetic patients (test) and nondiabetic subjects (control) for cognitive decline using the Montreal Cognitive Assessment (MoCA) tool. Cognitive functions such as visuospatial/executive function, naming, attention, language, abstraction, delayed recall, and orientation were assessed in both groups. The diabetic group showed a significantly lower total MoCA score than the non-diabetic group (18.99 ± 0.48 and 26.21 ± 0.46, respectively; p < 0.001). Assessment of scores in diabetic patients demonstrated the significant influence of age demographics on cognitive impairment (p-value < 0.001). Furthermore, a higher proportion of diabetic patients displayed cognitive impairment despite a higher score in a single subdomain, making it evident that diabetes is diverse and multifactorial in origin, where oxidative stress and inflammatory responses play a predominant role. This study suggested that the local T2DM population residing in Mysuru (India) has a high prevalence of cognitive impairment, evident from poor performance in almost all cognitive domains assessed by MoCA. Future studies could examine the generalizability of cognitive function findings in diabetic patients across diverse geographic regions and ethnic groups, as well as investigate interventions such as lifestyle modifications and medication to prevent or delay cognitive decline in those with diabetes.

Exploring the Relationship between Balance and Cognition in Middle-Aged Individuals with Diabetes and Hypertension: A Cross-sectional Study

“…Type 2 diabetes may hasten the natural ageing process in several body systems, resulting in impairments. 19 It was observed in the current study that T2DM patients had lower MoCA scores 19 than non-diabetic subjects, which could be due to a longterm hyperglycaemic state in blood vessels, which could hasten neurodegenerative changes in the brain, thereby leading to cognitive impairment. In a study of 448 older adults, it was found that diabetes was linked to a more rapid decline in MMSE over a span of 9 years.…”

Connections between Cognitive Impairment and Atrial Fibrillation in Patients with Diabetes Mellitus Type 2

“…The model had a sensitivity of 78.57%, a specificity of 57.69%, a PPV of 66.67%, and a NPV of 71. 43 The area under the ROC curve for this model (Figure 1) was 0.701 (AUROC = 0.701, 95%CI: 0.559; 0.844, p = 0.011). In the cumulated population (Group A and B), the same probability can be estimated by the formula: exp(RS)/(1 + exp(RS)), where RS = 0.116+ 0.116 × (age) + 1.081 × (hyperlipemia), where hyperlipemia is 1 if the patient has hyperlipemia and 0 if the patient does not.…”

“…A study carried out in India that evaluated the presence of CD in diabetic patients by evaluating the MoCA concluded that its scores were statistically significantly lower in patients with DM-2 compared to those without ( p < 0.001). In patients with DM-2, MoCA assessment indicated the significant influence of age on CD ( p < 0.001) [ 43 ]. Another study following 3687 participants over 6 years, of whom 6.4% had DM-2, indicated that both MMSE and MoCA scores were lower in patients with DM-2 compared to those without.…”

Clinical characteristics and healthcare utilisation associated with undiagnosed cognitive impairment in elderly patients with diabetes in a primary care setting: a population-based cohort study

“…Likewise, in a cross-sectional study in Mysuru, India, patients with diabetes had a lower mean MoCa score than patients without diabetes (18.99±0.48 vs 26.21±0.46). However, this study excluded elderly patients (>60 years) and did not exclude patients with a prior diagnosis of cognitive impairment 17. In contrast, our study is unique as we demonstrate a previously unreported very high prevalence of severe cognitive impairment in elderly patients with diabetes and without a previous diagnosis of cognitive impairment.…”