Cognitive Impairment and Related Factors Among Middle-Aged and Elderly Patients with Type 2 Diabetes from a Bio-Psycho-Social Perspective

Abstract

This study investigated the biomedical, psychological, and social behavior risk factors for cognitive impairment in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study included 240 patients with T2DM. A questionnaire was used to collect demographic and disease-related data on patients, and the Self-rating Depression Scale (SDS), Diabetes Self-care Scale (DSCS), and Social Support Rating Scale (SSRS) were used to assess patients' depression status, self-management behavior, and social support, respectively. The Chinese version of the Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive function, with a score <26 set as the threshold for cognitive impairment. Results: The prevalence of cognitive dysfunction in middle-aged and elderly patients with T2DM was 52.5%. Multivariate logistic regression analysis showed that older age, a history of hypoglycemia within 1 month, and depression were independent risk factors for cognitive impairment. Education for >12 years, urban living, and a higher total score on the DSCS were independent protective factors against cognitive impairment. Conclusion: T2DM patients with high risk of cognitive impairment can be identified early from the bio-psycho-social perspective. Patients with T2DM who are older, less educated, living in rural areas, have hypoglycemia history, and have poor self-management of diabetes are at increased risk of cognitive impairment. Closer monitoring of patients with hypoglycemia, early detection of depression, and improving patients' self-management capacity can prevent cognitive impairment in middle-aged and elderly patients with T2DM.

A Scoping Review on Biopsychosocial Predictors of Mental Health among Older Adults

“…One of the biological factors that influence mental health is age. It has been discovered that older age is a risk factor for cognitive impairment, mental health, and life quality [ 28 , 29 , 30 ]. An aging body experiences involutional changes in various systems and organs, which leads to a decrease in overall efficiency, the coexistence of diseases, and changes in symptomatology [ 31 ].…”

An exploratory pilot study on the involvement of APOE, HFE, C9ORF72 variants and comorbidities in neurocognitive and physical performance in a group of HIV-infected people

“…In our study only 17% of patients had diabetes. It is known that people with diabetes, especially with poor glycemic control, are more vulnerable to cognitive dysfunction and diabetes is associated with reduced cognitive function (Callisaya et al 2019 ; Sun et al 2020 ; Xu et al 2021 ). We indeed found that HIV-infected subjects with diabetes in our cohort had a lower MMSE score, confirming the above observations.…”

“…Our work has some strengths, to our knowledge it was one of the first studies that compares genetic polymorphisms, comorbidities, HIV-related values, and neurocognitive outcomes in HIV-infected patients. Previously, several authors studied the possible correlation between genetic polymorphisms, comorbidities or HIV-related values and neurocognitive outcomes in PWH (Foley et al 2010 ; Fogel et al 2015 ; Monroe et al, 2017; Callisaya et al 2019 ; Sun et al 2020 ; Buyo et al 2020 ; Levine et al, 2020 ; Ojeda-Juarez and Kaul, 2021 ; Xu et al 2021 ; Tahmi et al 2021 ). Notwithstanding, the combination of cognitive and physical functionality with genetic, comorbidities and HIV related values has never been assessed.…”

“…Therefore, HAND may be driven by several mechanisms, HIV-induced inflammation probably being the main driving factor, while ART, comorbidities, life-style and genetic background being possible exacerbating determinants. While genetic susceptibility is a non-modifiable risk factor for cognitive impairment, modifiable risk factors provide an opportunity for intervention and prevention of cognitive ability alterations and they have been studied in both HIV-infected and uninfected individuals (Foley et al 2010 ; Fogel et al 2015 ; Callisaya et al 2019 ; Sun et al 2020 ; Buyo et al 2020 ; Xu et al 2021 ; Tahmi et al 2021 ).…”

The health-related quality of life among the elderly in northwest China

“…Population aging is a serious social problem facing all countries in the world [1], meanwhile, the elderly in China accounted for 16.3% of the total population in 2017 and are expected to reach 492 million, or 35.2%, by 2050 [2], most of elderly have physiological function decline, malnutrition, the coexistence of a variety of chronic diseases and mental mild depression and other prominent health problems, type2 diabetes mellitus [3], cardiovascular disease [4], cognitive impairment [5] and obesity [6] are most common in elderly. Obesity is one of the most neglected health problems in the elderly, which is the accumulation of excess fat that can damage health and is a signi cant hazard to people.…”