Endocrine Abstracts

Background: Screening for cognitive impairment (CI) that is strongly recommended in elderly with diabetes mellitus (DM) type 2 but in fact is not commonly fulfilled.

Objectives: To evaluate cognitive state in elderly patients with type 2 diabetes mellitus.

Methods: In this cross-sectional study all patients with DM type 2 in age 65 and older who were on a planned admission in endocrinology department University Hospital named after V. Vasilenko were included except those with previous diagnosed dementia and vision or hearing loss. All participants underwent standard examination according national guidelines for DM (2019) and battery of neurocognitive tests: Mini-Mental State Examination (MMSE: 28-30 score normal cognition, 25-27 score mild CI, ≤24 score severe CI), Russian version of 12-word Philadelphia verbal learning test (PVLT: normal cognition ≥20 score), сlock drawing test (severe praxis impairment<8 score), trail Making Test (ТМТ-А: >90 sec severe bradyphrenia), Frontal Assessment Battery (FAB: 16-18 score normal cognition, 12-15 score mild frontal disorder,<12 score severe CI). Data processed in IBM SPSS Statistics 26.

Results: Between November 2019 and April 2021 we enrolled 217 patients in age 72 [68-77] years. Most of them were retired (87%) woman (72%) with a higher education (53%). Mean DM duration was 13 [8-20] years. Average HbA1c was 9.2% [8.2-10.1]. Every third patient mentioned at least one hypoglycemia over the year. Stroke history had 13.4%. Complain of memory loss had 70% participants. MMSE found out 33.5% prevalence of mild CI and 9.7% prevalence of severe CI. PVLT showed memory impairment as common as 74%. Severe bradyphrenia was found in 19.4% of patient, severe praxis impairment in 29%. Mild frontal disorder was found in 32% while 7% of patients had severe.

Conclusions: Elderly with DM type 2 have wide range of CI that may affect self-management and therapeutic education efficacy and compliance and so cognitive screening should be performed routinely.