[Cognitive functions assessment of elderly patients with type 2 diabetes mellitus]

OBJECTIVE

Comparative assessment of the cognitive status of persons over 60, depending on the presence or absence of type 2 diabetes mellitus (T2DM).

MATERIAL AND METHODS

The study included 193 patients, of which 93 had no T2DM and 100 had T2DM. The mean age of patients with T2DM was 73 [68; 78] years vs. 69.2 [64; 75] years in patients without T2DM. The cognitive function was assessed using the McNair and Kahn scale, with scores over 42 indicating cognitive dysfunction and Kahn scale: in the group with T2DM, the average score was 27.0±9.36; in the group without T2DM, it was 22.0±9.60 (p<0.043). The absence of T2DM was negatively correlated with the total score on the scale for assessing the risk of cognitive impairment (p=-0.264, p<0.001). In addition, it was found that age over 75 years was significantly associated with the development of cognitive impairment, regardless of the presence of concomitant T2DM (OR=1.247, CI=95%, 1.112-1.40, p<0.001).

CONCLUSION

T2DM increases the risk of developing cognitive dysfunction, which should be taken into account in older patients for the timely detection and prevention of its progression.

[Drug-induced cognitive impairment and dementia]

One of the reasons for the development or worsening of cognitive impairment (CI) may be the use of a number of drugs: non-steroidal anti-inflammatory drugs, antiarrhythmics, antidepressants, glucocorticosteroids, antitumor drugs and a number of others. The negative effect of drugs on cognitive functions is realized due to many pathophysiological mechanisms: disruption of hormonal regulation, decreased neuronal excitability, increased activity of gamma-aminobutyric acid receptors, decreased cerebral circulation, atrophic changes in the brain; many mechanisms have not been fully established. Risk factors for the development of drug-induced CIs are: old age or childhood, brain damage, chronic diseases, genetic factors, the patient's initial CI, polypharmacy, dose and duration of drug use, acute infectious diseases, metabolic disorders, dehydration, acute urinary retention, etc. To diagnose and differentially diagnose drug-induced CI, it is necessary to establish a connection between the start of taking a suspected drug-inducer and a decrease in cognitive functions. The first step in the treatment of drug-induced CI is the abolition of an inducer drug or a reduction in its dose, in cases where it is impossible to discontinue the drug and there is no replacement, special slow-release dosage forms can be considered. The main measures to prevent drug-induced CI include the use of drugs with the lowest risk of their development, assessment of drug interactions, and the use of modern scales to assess the risk of developing this side-effect (anticholinergic burden scale, etc.).

[Cerebrovascular disease in patients with type 2 diabetes mellitus]

The article discusses the current trends in the spread of carbohydrate disorders, discusses in more detail the problem of type 2 diabetes mellitus and associated cerebrovascular diseases. The spectrum of the therapeutic effect of the drugs neurox and neupilept is considered in relation to this category of patients.