The prevalence and predictors of cognitive impairment in type 2 diabetic population of Punjab, India

Abstract

Abstract Background: The present cross sectional study was carried out on 516 subjects with type 2 diabetes from a tertiary health care hospital to identify the prevalence and predictors of cognitive impairment in diabetes. Materials and Methods: Cognitive impairment was tested using Mini Mental Scale Examination (MMSE), Trail making tests-A and B (TMT-A and TMT-B). Efficiency of these tests to diagnose cognitive impairment was analysed using reliability index (Cronbach's α = 0.82), which ruled out any internal inconsistency. Of the study participants, 174 (33.73%) met the criteria for cognitive impairment and 342 (66.27%) were having normal cognition. Out of 174, 156 diabetic subjects (89.65 percent) were not diagnosed for neurocognitive impairment prior participation. Results: Cognitive impairment was observed to be strongly associated with being a woman (P < 0.001), divorced or separated (P = 0.007), sedentary life style (P = 0.001), smoking (P < 0.001), drinking alcohol (P < 0.001), systolic blood pressure >120 mmHg (P = 0.003), triglycerides (TG) >150 mg/dl (P = 0.001), high density lipoprotein <40 mg/dl (P = 0.001), statin use (P = 0.009), waist hip ratio in both males and females (P = 0.001), glucose levels >125 mg/dl (P = 0.005) and duration of diabetes >2 years upto 10 years and more than 10 years (P = 0.001) in univariate testing. In multivariate logistic regression model, being a woman was an independent risk factor for cognitive decline, which is two fold higher (OR 2.00 95%CI 1.25-3.20, P = 0.004) than being a man. Other risk factors like glucose levels > 125 mg/dl, systolic blood pressure >120 mmHg, sedentary life style and duration of diabetes >10 years emerged as independent predictors of cognitive impairment in diabetes. Conclusion: In conclusion, the present study revealed that higher prevalence of cognitive impairment in diabetes is evident in population of Punjab, especially in women and majority of these patients remain undiagnosed for it.