Prevalence of Cognitive Impairment in Recently Diagnosed Type 2 Diabetes Patients: Are Chronic Inflammatory Diseases Responsible for Cognitive Decline?

Prevalence of Cognitive Impairment and Associated Factors Among Diabetes Mellitus Patients Attending Follow-up Treatment at Fiche General Hospital, North Ethiopia

Introduction

Cognitive impairment is having trouble remembering, learning new things, concentrating, or making decisions that affect the daily life of diabetic patients. The worldwide prevalence of diabetes mellitus (DM) was 2.8% in 2000 and is estimated to be 4.4% by 2030.

Objective

To assess the prevalence of cognitive impairment and associated factors among DM patients attending follow-up treatment at Fiche General Hospital, North Ethiopia, 2022.

Methods

A hospital-based cross-sectional study was conducted from July 15 to September 15, 2022. The total sample size was 421 and a systematic random sampling technique was used. Data were collected through a face-to-face interview. Data were entered using EpiData Version 3.1 and exported to SPSS Version 24 for analysis. Statistically significant was declared at a P-value of less than .05 with an adjusted odds ratio (AOR) and 95% confidence interval (CI).

Result

The prevalence of cognitive impairment in the current study was 56.3% with (95% CI: 51.5-60.8). Primary educational status (AOR 6.73, 95% CI: 2.92-15.51), having Type II DM (AOR 4.93, 95% CI: 2.84-8.56), uncontrolled blood sugar (AOR 6.24, 95% CI: 3.84-10.17), and current alcohol use (AOR 1.94, 95% CI: 1.11-3.36) were significantly associated.

Conclusion

About three in 5 DM patients attending follow-up treatment at Fiche General Hospital were suffering from cognitive impairment. Educational status, type of DM, status of fasting blood sugar, and current alcohol use were associated with cognitive impairment among DM patients. Therefore, improving educational status, controlling blood sugar, and avoiding alcohol use may reduce the risk of cognitive impairment in DM patients.

Asthma, the central nervous system, and neurocognition: Current findings, potential mechanisms, and treatment implications

Accumulating behavioral evidence suggests that asthma is associated with cognitive deficits. A number of studies have identified potential biological contributions to cognition in asthma; however, mechanistic pathways of central nervous system (CNS) involvement in asthma are yet to be established. We therefore conducted a literature review to identify studies examining potential CNS contributions to cognition in asthma. In this review, we discuss our general understanding of the CNS in asthma in the context of cognitive performance and outline a working model of mechanistic pathways linking the proposed neural influences of asthma pathology with cognition. To this extent, we incorporate neural, behavioral, psychological, social and environmental factors. Finally, we underscore the clinical significance of the CNS and neurocognitive sequelae in asthma, highlighting potential opportunities for routine monitoring, therapeutic intervention, and recommend key areas for future research.

Prevalence of Psychiatric Morbidity and Cognitive Impairment among Patients Attending the Rural Noncommunicable Disease Clinic

Objective  This study aimed to assess the prevalence of cognitive impairment and psychiatric morbidity among the patients attending the rural noncommunicable disease clinic after controlling for various confounders (i.e., psychological morbidity, obesity, gender, level of education, duration of the illness and age).

Materials and Methods  One-hundred twenty-four patients were evaluated on the Hindi Mental State Examination for the cognitive function, Physical Health Questionnaire-9 for depression, and Generalized Anxiety Disorder-7 for anxiety disorders.

Results  About one-fourth (26.6%) of the participants had cognitive impairment. The prevalence of cognitive impairment was more among patients with hypertension (35.5%) as compared with the diabetes mellitus (13.6%) and those with comorbid hypertension and diabetes mellitus (26.6%). About one of the participants had depression (35.5%) and 29% of the patients had anxiety disorder. No significant difference was found in the level of cognitive deficits between those with hypertension and diabetes mellitus, when the confounding factors were not taken into account in the analysis. However, after controlling for psychiatric morbidity, obesity, gender, level of education, duration of the illness and age, those with hypertension were found to have significantly higher level of cognitive impairment compared with those with diabetes mellitus. A higher level of dysfunction was seen in the domains of orientation, registration, attention, recall, language, and visuospatial domains.

Conclusion  Present study suggests that patients of hypertension have higher level of cognitive impairment, when compared with those with diabetes mellitus, even after controlling for various confounders. Lack of difference between the two groups can be accounted by the confounding variables.

The neuroprotective effect and action mechanism of polyphenols in diabetes mellitus-related cognitive dysfunction

BACKGROUND

Diabetes mellitus (DM) is a complex and prevalent metabolic disorder worldwide. Strong evidence has emerged that DM is a risk factor for the accelerated rate of cognitive decline and the development of dementia. Though traditional pharmaceutical agents are efficient for the management of DM and DM-related cognitive decrement, long-term use of these drugs are along with undesired side effects. Therefore, tremendous studies have focused on the therapeutic benefits of natural compounds at present. Ample evidence exists to prove that polyphenols are capable to modulate diabetic neuropathy with minimal toxicity and adverse effects.

PURPOSE

To describe the benefits and mechanisms of polyphenols on DM-induced cognitive dysfunction. In this review, we introduce an updated overview of associations between DM and cognitive dysfunction. The risk factors as well as pathological and molecular mechanisms of DM-induced cognitive dysfunction are summarized. More importantly, many active polyphenols that possess preventive and therapeutic effects on DM-induced cognitive dysfunction and the potential signaling pathways involved in the action are highlighted.

CONCLUSIONS

The therapeutic effects of polyphenols on DM-related cognitive dysfunction pave a novel way for the management of diabetic encephalopathy.

Biomarkers for cognitive decline in patients with diabetes mellitus: evidence from clinical studies

Diabetes mellitus is considered as an important factor for cognitive decline and dementia in recent years. However, cognitive impairment in diabetic patients is often underestimated and kept undiagnosed, leading to thousands of diabetic patients suffering from worsening memory. Available reviews in this field were limited and not comprehensive enough. Thus, the present review aimed to summarize all available clinical studies on diabetic patients with cognitive decline, and to find valuable biomarkers that might be applied as diagnostic and therapeutic targets of cognitive impairment in diabetes. The biomarkers or risk factors of cognitive decline in diabetic patients could be classified into the following three aspects: serum molecules or relevant complications, functional or metabolic changes by neuroimaging tools, and genetic variants. Specifically, factors related to poor glucose metabolism, insulin resistance, inflammation, comorbid depression, micro-/macrovascular complications, adipokines, neurotrophic molecules and Tau protein presented significant changes in diabetic patients with cognitive decline. Besides, neuroimaging platform could provide more clues on the structural, functional and metabolic changes during the cognitive decline progression of diabetic patients. Genetic factors related to cognitive decline showed inconsistency based on the limited studies. Future studies might apply above biomarkers as diagnostic and treatment targets in a large population, and regulation of these parameters might shed light on a more valuable, sensitive and specific strategy for the diagnosis and treatment of cognitive decline in diabetic patients.