To evaluate the prevalence, subtypes and risk associations of mild cognitive impairment in elderly Indian individuals with type 2 diabetes

Abstract

AbstractBackgroundDiabetes is an important modifiable risk factor for dementia. The prevalence of mild cognitive impairment (MCI) in type 2 diabetes (T2D) is high (You et al, 2021). This data is largely derived using screening tools (MMSE or MoCA), with little information on MCI subtypes. Evidence from the South Asian region is particularly scarce, where prevalence of diabetes is high, and is seen a decade earlier compared to Caucasians.MethodWe have established a cohort of elders (³ 60 years of age), with and without diabetes, visiting a tertiary care hospital in North India (from 2019, ongoing). The participants underwent an interview to collect information on their demographic profile, risk associations, vascular health, and other comorbidities. Culturally validated neuropsychological battery was used for cognitive evaluation. MoCA was done in a subset of patients.ResultWe recruited 840 participants in the cohort, 683 with T2DM and 157 without T2DM (controls). The mean age of the cohort was 65.3±4.5 years, 65.2% were males. Risk profile is described in Table 1. The cognitive z scores of participants with T2DM ranged from ‐0.25 to +0.44. The worst affected domain was attention, working memory and executive functions (Table 2). Using an actuarial definition of MCI (Bondi MW et al, 2014), the prevalence in participants with T2D was 29.7%. 17.3% had amnestic impairment, 14.8% dysexecutive, 14.2% language, 2.4% visuo‐perceptual and 9.1% multidomain impairment. The cognitive raw scores (by dementia risk stratification) are provided in Table 3. On logistic regression, lower education 3.45(2.09,5.68), depression 2.04(1.26,3.29), poor sleep quality 1.77(1.15,2.71), family income 1.70(1.22,2.38), followed by age 1.05(1.00,1.10) had a significant association with global low cognition.ConclusionRoughly one‐third of elders with T2D visiting tertiary care services in North India have mild cognitive impairment. Amnestic subtype is the most frequent. Attention, working memory and executive functions are worst affected. Enhancing the cognitive reserve, mood and sleep quality may be important targets in prevention of cognitive decline in the elderly population with T2D.