Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University, Tokyo, Japan.
Endocr J. 2011;58(2):109-15. doi: 10.1507/endocrj.k10e-388. Epub 2011 Jan 25.
Despite numerous reports that have linked diabetes with cognitive impairment (CI), there are few studies that have attempted to clarify the morbidity of CI among elderly diabetic patients. The Mini-Mental State Examination (MMSE) was performed on 240 diabetic patients aged 65 years or older who had no diagnosis of dementia. The MMSE scores were 28-30 (normal range) in 151 patients (63%), 24-27 (suspected CI) in 77 (32%), and ≤ 23 (definite CI) in 12 (5%). Eight of the 12 patients with MMSE scores ≤ 23 underwent further detailed examination: the final diagnosis was Alzheimer's disease (AD) (N = 5), vascular dementia (N = 2), and mixed dementia (N = 1). Among 24 of the 77 patients with MMSE scores of 24-27 who were referred for further detailed examination, the final diagnosis was early AD (N = 5), cerebrovascular disease (CVD) (N = 10), and mild CI (N = 7). Only 2 of the patients were judged as being normal. The percentage of patients with a history of CVD, the rate of diuretic use, and the serum levels of non-high-density lipoprotein cholesterol were higher, and the percentage of patients with a history of habitual alcohol consumption was lower in the low MMSE score group than in the normal MMSE score group. Among elderly diabetic patients aged 65 years or older, 5% had evident CI and 32% had suspected CI. Medical staff involved in the care of diabetic patients should be highly aware of possible CI in this patient population.
尽管有大量报告将糖尿病与认知障碍 (CI) 联系起来，但很少有研究试图阐明老年糖尿病患者 CI 的发病率。对 240 名年龄在 65 岁或以上且没有痴呆诊断的糖尿病患者进行了 Mini-Mental State Examination (MMSE)。151 名患者 (63%) 的 MMSE 评分为 28-30(正常范围)，77 名患者 (32%) 的评分为 24-27(疑似 CI)，12 名患者 (5%) 的评分为 ≤ 23(明确 CI)。12 名 MMSE 评分 ≤ 23 的患者中有 8 名接受了进一步的详细检查：最终诊断为阿尔茨海默病 (AD) (N = 5)、血管性痴呆 (N = 2) 和混合性痴呆 (N = 1)。在 24 名 MMSE 评分在 24-27 之间被转诊进行进一步详细检查的患者中，最终诊断为早期 AD (N = 5)、脑血管疾病 (CVD) (N = 10) 和轻度 CI (N = 7)。只有 2 名患者被判断为正常。低 MMSE 评分组的患者中有 CVD 病史的比例、利尿剂使用的比率、非高密度脂蛋白胆固醇的血清水平较高，而有习惯性饮酒史的患者比例较低。在 65 岁或以上的老年糖尿病患者中，5%有明显的 CI，32%有疑似 CI。照顾糖尿病患者的医务人员应高度意识到该患者群体中可能存在 CI。
