Detection of cognitive impairment in Type 2 diabetes mellitus by choice auditory and visual reaction times during acute mental stress: A case-control study

Abstract

Background: Cognitive dysfunction in Type 2 diabetes mellitus (DM) can be unveiled by stress test even before it develops at rest. Mental stress testing is easier to administer and can be precisely regulated by the investigator. Mental arithmetic using serial subtraction is the most widely used method to administer stress. Reaction time (RT) widely used to assess cognitive domains such as attention, execution, and psychomotor speed. Investigators have shown that choice RTs are delayed in Type 2 DM. Aim and Objectives: The objective of the present study was to assess cognitive dysfunction in Type 2 DM during acute mental stress without overt cerebrovascular disease or other vascular risk factors. Materials and Methods: After getting medical ethical clearance of our institution, 60 subjects between the given age group (35–55 years) were enlisted in the study. They were categorized into two groups. Group 1 had 30 diagnosed cases of Type 2 DM at least 2 years of duration. Group 2 had 30 gender and age-matched controls. Mini-mental status examination was performed to assess global cognitive function in these groups. Simple and choice auditory and visual RTs (VRTs) were measured during rest and during acute mental stress in these groups to assess cognitive function. Results: There was a significant difference in auditory RT and VRT, both simple and choice in Type 2 DM and controls and these RTs further increased during mental stress (P < 0.001). Conclusion: Cognitive function in Type 2 DM deteriorates with acute mental stress.