Cognitive Dysfunction Among Adults With Type 2 Diabetes Mellitus in Karnataka, India

Abstract

Background: Type 2 diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia that affects various body systems. Elevated blood glucose levels cause brain malfunction, sorbitol-induced blood vessel damage, and degeneration of the nerves that can lead to dementia or cognitive impairment. Cognitive impairment can result in nonadherence of patients to diabetes treatment, such as diet, medication, and exercise. Methods: We used a cross-sectional design to individually interview 194 patients with type 2 diabetes in a rural field practice area in India. A questionnaire was used to collect sociodemographic and diabetes disease characteristics; anthropometric measurements were also collected. Cognitive dysfunction was assessed with the Kannada version (local language) of the Montreal Cognitive Assessment (MoCA) tool. Blood pressure was measured for all subjects using a standardized sphygmomanometer on the right arm with the patient in a sitting position. Results: Among the 194 diabetic subjects interviewed, 98 (50.5%) were cognitively impaired. More than half of the subjects (56.2%) were ≥65 years, and female participants (53.6%) outnumbered males (46.4%). The majority of patients (62.4%) had had diabetes for <10 years. The sociodemographic characteristics age, sex, education, occupation, and socioeconomic status and the anthropometric measurement of waist-to-hip ratio were significantly associated (P<0.05) with cognitive impairment. Disease characteristics, religion, and blood pressure showed no significant association with cognitive impairment. Conclusion: One in two individuals with type 2 diabetes mellitus in our study population had mild cognitive impairment. Older individuals in the low socioeconomic strata and with low levels of education were identified to be at high risk of cognitive impairment. Hence, screening and appropriate care need to be provided.