The prevalence of mild cognitive impairment in type 2 diabetes mellitus patients: a systematic review and meta-analysis

You, Yue; Liu, Zhizhen; Chen, Yannan; Xü, Ying; Qin, Jiawei; Guo, Shuai; Huang, Jia; Tao, Jing

doi:10.1007/s00592-020-01648-9

Cited by 134 publications

(100 citation statements)

References 49 publications

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“…The prevalence of cognitive impairment in older Thai adults with diabetes in this study was high (54.5%) compared to other studies worldwide which varied widely from 9.1% to 45% [17, 19, 21, 25-27, 31, 34]. The cause might be the disparity in sensitivity for detecting cognitive impairment of each cognitive assessment tool or the differences in the sociodemographic and health characteristics of the study population.…”

Section: Discussioncontrasting

confidence: 59%

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

Panyawattanakit¹,

Wongpradit²,

Kanhasing³

et al. 2022

Dement Geriatr Cogn Disord

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Introduction: 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. Methods: 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. Results: 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, p value 0.048), ages ≥80 years compared to ages 60–69 years (OR 3.65, 95% CI: 1.19–11.24, p value 0.024), education ≤ primary school (OR 7.28, 95% CI: 3.56–14.89, p value <0.001), and medication managed by caregiver compared to self-management of medication (OR 13.40, 95% CI: 1.55–116.10, p value 0.019). Conclusion: 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.

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Section: Discussioncontrasting

confidence: 59%

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

Panyawattanakit¹,

Wongpradit²,

Kanhasing³

et al. 2022

Dement Geriatr Cogn Disord

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“…The characteristics of cognitive impairment in T2DM are the most obvious obstacle to learning and memory (Awad et al, 2004 ; Messier, 2005 ; van den Berg et al, 2010 ; McCrimmon et al, 2012 ). Over time, the decline in cognitive function can lead to faster aging of the central nervous system or increased risk of neurodegenerative diseases, such as Alzheimer's disease (AD) (Cheng et al, 2012 ; Verdile et al, 2015 ; Cheong et al, 2020 ; You et al, 2021 ). Therefore, T2DM would seriously affect the quality of life in T2DM patients, while aggravating the social burden to some extent.…”

Section: Introductionmentioning

confidence: 99%

Altered Structural and Functional MRI Connectivity in Type 2 Diabetes Mellitus Related Cognitive Impairment: A Review

Lei

Luo

et al. 2022

Front. Hum. Neurosci.

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Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment in many domains. There are several pieces of evidence that changes in neuronal neuropathies and metabolism have been observed in T2DM. Structural and functional MRI shows that abnormal connections and synchronization occur in T2DM brain circuits and related networks. Neuroplasticity and energy metabolism appear to be principal effector systems, which may be related to amyloid beta (Aβ) deposition, although there is no unified explanation that includes the complex etiology of T2DM with cognitive impairment. Herein, we assume that cognitive impairment in diabetes may lead to abnormalities in neuroplasticity and energy metabolism in the brain, and those reflected to MRI structural connectivity and functional connectivity, respectively.

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“…(6). A recent meta-analysis data from 12 studies revealed the global prevalence of MCI at 45% (7) with the lowest reported prevalence of 21.8% (8) and the highest prevalence of 67.5% (9) among 256 and 400 T2DM patients evaluated, respectively (7). The majority of the previous studies have performed cognitive analyses in T2DM patients either above 60 or 65 years.…”

Section: Introductionmentioning

confidence: 99%

Age Related Prevalence of Mild Cognitive Impairment in Type 2 Diabetes Mellitus Patients in the Indian Population and Association of Serum Lipids With Cognitive Dysfunction

et al. 2021

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The magnitude of type 2 diabetes mellitus (T2DM) is ever-increasing in India, and at present, ~77 million people live with diabetes. Studies have established that T2DM increases the risk of neurodegenerative disorders. This study aimed to determine the age-related prevalence of mild cognitive impairment (MCI) in T2DM patients in the Indian population and to identify link between cognitive dysfunction in T2DM patients and serum lipid composition through untargeted and targeted lipidomic studies. Using a cross-sectional study, we evaluated 1278 T2DM patients with Montreal cognitive assessment test (MoCA) and digit symbol substitution test (DSST) for cognitive functions. As per MoCA, the prevalences of MCI in T2DM patients in age groups below 40, 41-50, 51-60, 61-70, 71-80 and 81-90 years were 13.7, 20.5, 33.5, 43.7, 57.1 and 75% with DSST scores of 45.8, 41.7, 34.4, 30.5, 24.2 and 18.8% respectively. Binomial logistic regression analysis revealed serum HbA1c ≥ 7.51, duration of T2DM over 20 years, age above 41 years, and females were independent contributors for cognitive dysfunction in T2DM patients. Preliminary studies with untargeted lipidomics of the serum from 20 T2DM patients, including MCI and normal cognition (NC) group, identified a total of 646 lipids. Among the identified lipids, 33 lipids were significantly different between MCI and NC group, which comprised of triglycerides (TGs, 14), sphingolipids (SL, 11), and phosphatidylcholines (PC, 5). Importantly, 10 TGs and 3 PCs containing long-chain polyunsaturated fatty acids (PUFA) were lower, while 8 sphingolipids were increased in the MCI group. Since brain-derived sphingolipids are known to get enriched in the serum, we further quantified sphingolipids from the same 20 serum samples through targeted lipidomic analysis, which identified a total of 173 lipids. Quantitation revealed elevation of 3 species of ceramides, namely Cer (d18:1_24:1), Hex1Cer (d16:0_22:6), and Hex2Cer (d28:1) in the MCI group compared to the NC group of T2DM patients. Overall, this study demonstrated an age-related prevalence of MCI in T2DM patients and highlighted reduced levels of several species of PUFA containing TGs and PCs and increased levels of specific ceramides in T2DM patients exhibiting MCI. Large-scale lipidomic studies in future could help understand the cognitive dysfunction domain in T2DM patients, while studies with preclinical models are required to understand the functional significance of the identified lipids.

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The prevalence of mild cognitive impairment in type 2 diabetes mellitus patients: a systematic review and meta-analysis

Cited by 134 publications

References 49 publications

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

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

Altered Structural and Functional MRI Connectivity in Type 2 Diabetes Mellitus Related Cognitive Impairment: A Review

Age Related Prevalence of Mild Cognitive Impairment in Type 2 Diabetes Mellitus Patients in the Indian Population and Association of Serum Lipids With Cognitive Dysfunction

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