Abstract
BackgroundThe type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D. T2D-related factors have been shown increase the risk of age-related conditions, which might also increase dementia risk. Here, we investigate the associations of DSDRS with frailty, disability, quality of life (QoL) and cognition in community-dwelling older adults with T2D.MethodsWe included 257 community-dwelling older adults with T2D to evaluate the association between DSDRS and Mini-mental state examination (MMSE), Isaac’s set-test (IST), clock drawing test (CDT), quality of life (SF-36), risk of malnutrition (Mini-Nutritional Assessment or MNA), as well as frailty, Katz’ and Lawton-Brody scores. We also assessed the phenotype and correlates of high-estimated dementia risk by assessing individuals with DSDRS >75th age-specific percentiles.ResultsMean age of participants was 78.0 ± 6.2 years. DSDRS showed a significant correlation with MMSE test, IST, CDT, SF-36, MNA, Lawton-Brody and Katz scores, and an increasing number of frailty components. DSDRS was higher among frail, pre-frail, and subjects with limited ADL and IADL (p < 0.001). Participants with DSDRS >75th age-specific percentiles had lower education, MMSE, IST, SF-36, MNA, Katz, Lawton-Brody, and higher frailty scores. High-estimated 10-year dementia risk was associated with ADL and IADL disability, frailty and risk of malnutrition. When assessing individual components of DSDRS, T2D-related microvascular complications were associated to all outcome measures.ConclusionThe DSDRS is associated with frailty, disability, malnutrition and lower cognitive performance. These findings support that T2D-related factors have significant burden on functional status, QoL, disability and dementia risk.
Highlights
The type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D
When assessing sex-specific differences in DSDR S components, we identified that female participants had less years of education (6.0 [2.0–11.0], P = 0.003) and higher but non-significant rates of microvascular complications (55.4% vs 43.2%, P = 0.051) and of diabetic foot (39.6% vs. 28.0%, p = 0.051) compared to men but significantly lower rates of acute metabolic events (3.6 vs. 11.9%, p = 0.012)
Using step-wise linear regression analyses we identified that frailty (β = 0.400, 95%CI 0.080–0.719), Mini-mental state examination (MMSE) (β = − 0.153 95%CI -0.255 - -0.050) and Mini-Nutritional Assessment (MNA) scores (β = − 0.160 95%CI -0.283 - -0.037) explained 26.8% of the variability in DSDRS, adjusted for sex, years of schooling and years since T2D diagnosis (R2 = 0.268, p < 0.001)
Summary
The type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D. We investigate the associations of DSDRS with frailty, disability, quality of life (QoL) and cognition in community-dwelling older adults with T2D. The diabetes-specific dementia risk score (DSDRS) was developed to evaluate dementia risk in American older individuals with T2D. Accumulated risk attributable to T2D-related factors has been independently associated to age-related conditions including frailty, disability and cognitive impairment [7]. The clinical utility of screening individuals using DSDRS might be approached with the aim of designing specific treatment regimens to improve quality of life (QoL) and functional status in at-riskolderadults[10].,sinceimpairedcognition and dementia have significant negative impacts on T2D selfcare, closer attention might be given to individuals identified at higher baseline risk [11]
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