The type 2 diabetes-specific dementia risk score (DSDRS) is associated with frailty, cognitive and functional status amongst Mexican community-dwelling older adults

Abstract

Background The 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. Methods We 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. Results Mean 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. Conclusion The 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.

New methods for the diagnosis and monitoring of cognitive function in patients with type 2 diabetes

“…The results showed that a cut-off of DSDRS≥7 had a predictive value of AUC 0.739 (CI95%, [0.557-0.921]) and of 0.902 (CI 95% [0.840-0.992]) when combined with MMSE ( 33 ), suggesting that DSRDS could be a reliable screening tool for cognitive decline in patients with T2D>65 years with a sensitivity 88.37% CI95% (78.9-97.9) and specificity 55.26% CI 95% (48.9-60.5). Additionally, a recent study from another group studied the utility of the DSDRS for lower cognitive performance and found similar results, with a sensitivity of 83.3% and specificity of 54.3% ( 31 ).…”

“…The DSDRS was not initially designed as a screening tool. Recently, as part of a European project ( 31 ),MOPEAD study ( 32 ), our research group evaluated the usefulness of the DSDRS as a screening tool for MCI, alone or combined with MMSE. The cognitive status of the patients was confirmed by neuropsycholgical tests battery performed by trained neuropsychologists at the memory clinic.…”

Application of Grey Relational Analysis to Predict Dementia Tendency by Cognitive Function, Sleep Disturbances, and Health Conditions of Diabetic Patients

“…They showed that higher DSDRS was associated with a higher probability of CI at baseline and follow-up. Omar et al [ 19 ] also adopted the DSDRS to predict cognitive performance risk. These findings support that T2D-related factors have a significant burden on functional status, quality of life, disability, and dementia risk.…”

Non-Contributory Pensions, Functional Limitations, and Unpaid Family Care for Older Adults in Mexico

“…Non-communicable chronic diseases generally have a long duration and steadily progress. They are an important source of functional limitations, disability, and frailty among older adults (Bello-Chavolla, et al, 2020; Jacob et al, 2020). Dependency associated with chronic diseases has created substantial health and financial burdens for older adults, their family caregivers, and the overall health care system (Mendoza-Núñez, et al, 2009).…”