University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Neurology, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Erasmus Medical Center, Department of Neurology, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Diabetes Res Clin Pract. 2018 Aug;142:92-99. doi: 10.1016/j.diabres.2018.05.025. Epub 2018 May 24.
Type 2 diabetes mellitus (T2DM) is associated with subtle cognitive changes, but also with more severe stages of cognitive dysfunction, including mild cognitive impairment (MCI) and dementia. For these severe stages, it is uncertain which domains are primarily affected and if all patients with impairment are captured by formal criteria for MCI or dementia.
Ninety-five patients with T2DM suspected of cognitive impairment, identified through screening in primary care, underwent neuropsychological examination assessing five different domains. MCI or dementia were diagnosed using formal criteria.
Forty-seven participants (49%) had impairment on at least one domain, most often involving memory (30%), information processing speed (22%) and visuoperception and construction (22%). Of these 47 people, 29 (62%) had multi-domain impairment. Of the 47 participants with objective impairment, 36 (77%) met criteria for MCI, three (6%) for dementia and eight (17%) met neither diagnosis, mostly because these patients did not complain about acquired dysfunction.
This study shows that the clinical diagnostic evaluation of cognitive impairment in patients with T2DM should take into account that multiple domains can be affected and that not all patients with objective cognitive impairment fulfill criteria for MCI or dementia.
2 型糖尿病（T2DM）与细微的认知变化有关，但也与更严重的认知功能障碍阶段有关，包括轻度认知障碍（MCI）和痴呆。对于这些严重阶段，尚不确定哪些领域受到主要影响，以及所有认知障碍患者是否都符合 MCI 或痴呆的正式标准。
95 名在初级保健中通过筛查怀疑有认知障碍的 T2DM 患者接受了神经心理学检查，评估了五个不同的领域。使用正式标准诊断 MCI 或痴呆。
47 名参与者（49%）在至少一个领域存在障碍，最常见的是记忆（30%）、信息处理速度（22%）和视知觉和构建（22%）。在这 47 人中，29 人（62%）存在多领域障碍。在 47 名有客观损害的参与者中，36 名（77%）符合 MCI 标准，3 名（6%）符合痴呆标准，8 名（17%）不符合这两种诊断，主要是因为这些患者没有主诉获得性功能障碍。
本研究表明，对 T2DM 患者认知障碍的临床诊断评估应考虑到多个领域可能受到影响，并且并非所有有客观认知障碍的患者都符合 MCI 或痴呆的标准。
