Department of Psychiatry, Alzheimer's Disease Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
James J. Peters VA Medical Center, New York, New York, USA.
J Diabetes. 2017 Oct;9(10):929-935. doi: 10.1111/1753-0407.12503. Epub 2016 Dec 22.
Diabetes mellitus is a risk factor for cognitive changes, but assessment for cognitive disorders in this population is performed infrequently. The present study examined the frequency of cognitive disorders and patterns of deficit in patients enrolled in a specialized clinic for diabetes.
A cross-sectional study was conducted to assess cognition in Mount Sinai Diabetes Center patients. Thirty eligible subjects aged ≥50 years were assessed and compared with non-diabetic cognitively normal control subjects, as well as non-diabetic subjects with mild cognitive impairment (MCI). The main outcome(s) and measure(s) were obtained through cognitive assessment and diagnosis using the Alzheimer's Disease Centers' uniform data set.
Forty percent of subjects were newly diagnosed with a cognitive disorder: 10% were diagnosed with dementia and 30% with MCI. Diabetic subjects performed worse on the Mini-Mental State Examination (27.2 vs 28.4; P = 0.0132), list generation (9.5 vs 12.2; P = 0.0190), Trail Making Test, Parts A (70.1 vs 43.0; P < 0.0001) and B (197.2 vs 123.6; P < 0.0001), and the Digit Symbol test (12.7 vs 40.1; P < 0.0001) than cognitively normal individuals. Compared with subjects with MCI (amnestic type), diabetic subjects performed better on tasks of immediate and delayed recall (11.2 vs 7.3 [P = 0.0048] and 8.4 vs. 4.1 [P = 0.0003], respectively).
Undiagnosed cognitive disorders are common and underappreciated in patients being treated in a specialized diabetes clinic. It may be important to make cognitive assessment a standard part of patient assessments.
糖尿病是认知功能改变的一个危险因素，但在该人群中对认知障碍的评估并不常见。本研究旨在探讨专门的糖尿病诊所患者认知障碍的发生频率和缺陷模式。
进行了一项横断面研究，以评估西奈山糖尿病中心患者的认知功能。对 30 名年龄≥50 岁的合格受试者进行评估，并与非糖尿病认知正常对照受试者以及非糖尿病轻度认知障碍（MCI）受试者进行比较。主要结局和测量指标是通过使用阿尔茨海默病中心的统一数据集进行认知评估和诊断获得的。
40%的受试者被新诊断为认知障碍：10%被诊断为痴呆，30%被诊断为 MCI。与认知正常个体相比，糖尿病患者在简易精神状态检查（27.2 分比 28.4 分；P=0.0132）、词语生成测试（9.5 分比 12.2 分；P=0.0190）、连线测试 A 部分（70.1 分比 43.0 分；P<0.0001）和 B 部分（197.2 分比 123.6 分；P<0.0001）以及数字符号测试（12.7 分比 40.1 分；P<0.0001）方面的表现更差。与 MCI（遗忘型）患者相比，糖尿病患者在即时和延迟回忆任务中的表现更好（11.2 分比 7.3 分[P=0.0048]和 8.4 分比 4.1 分[P=0.0003]）。
在专门的糖尿病诊所治疗的患者中，未诊断的认知障碍很常见，但未得到充分重视。将认知评估作为患者评估的标准部分可能很重要。
