Albai Oana, Frandes Mirela, Timar Romulus, Roman Deiana, Timar Bogdan
Second Department of Internal Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania,
Neuropsychiatr Dis Treat. 2019 Jan 3;15:167-175. doi: 10.2147/NDT.S189905. eCollection 2019.
Dementia and cognitive dysfunction have many causes. There is strong evidence that diabetes mellitus (DM) increases the risk of cognitive impairment and dementia. Optimal glycemic control, identification of diabetic risk factors, and prophylactic approach are essential in the prevention of cognitive complications.
The main purpose of this study was to establish the cognitive impairment in DM patients, cared for in the Diabetes Center from Timisoara. Also, we investigated the prevalence of dementia in our group as well as the risk factors involved in the progression of mild cognitive impairment (MCI) to dementia.
We considered a sample of 207 type 2 DM (T2DM) patients, aged between 33 and 81 years, mean 57.49 (±11.37) years. We established the diagnosis of dementia based on the Mini-Mental State Examination (MMSE) test, as well as on the psychological testing, psychiatric and neurological investigations, and imaging tests (computerized tomography and MRI).
A percentage of 42.03% of patients presented MCI, mean age 63 (57.00-71.00) years, being older than patients without MCI, mean age 52.00 (45.00-61.00) years, <0.001. We observed that diabetes duration was a significant risk factor for developing dementia. Also, patients with MCI presented higher values of body fat than patients without MCI. Moreover, we found that glucose levels, low-density lipoprotein cholesterol levels, the presence of stroke events, and the presence of cardiovascular disease were significant risk factors for MCI conversion to dementia.
Patients with T2DM at early to severe stages of MCI are more likely to develop dementia and should be regularly evaluated for their cognitive status. Regular administrations of the MMSE test can be done to detect early stages of MCI development. Also, to reduce the progression of cognitive impairment to dementia, it is worthwhile to give greater importance to glycemic control and overall DM management.
痴呆和认知功能障碍有多种病因。有强有力的证据表明，糖尿病会增加认知障碍和痴呆的风险。最佳血糖控制、糖尿病危险因素的识别以及预防措施对于预防认知并发症至关重要。
本研究的主要目的是确定在蒂米什瓦拉糖尿病中心接受护理的糖尿病患者的认知障碍情况。此外，我们还调查了我们研究组中痴呆的患病率以及轻度认知障碍（MCI）进展为痴呆所涉及的危险因素。
我们选取了207例2型糖尿病（T2DM）患者作为样本，年龄在33至81岁之间，平均年龄为57.49（±11.37）岁。我们基于简易精神状态检查表（MMSE）测试以及心理测试、精神和神经学检查以及影像学检查（计算机断层扫描和磁共振成像）来确定痴呆的诊断。
42.03%的患者存在MCI，平均年龄为63（范围57.00 - 71.00）岁，比无MCI的患者年龄大，无MCI患者的平均年龄为52.00（范围45.00 - 61.00）岁，P < 0.001。我们观察到糖尿病病程是发生痴呆的一个重要危险因素。此外，有MCI的患者比无MCI的患者体脂值更高。而且，我们发现血糖水平、低密度脂蛋白胆固醇水平、中风事件的发生以及心血管疾病的存在是MCI转化为痴呆的重要危险因素。
处于MCI早期至重度阶段的T2DM患者更有可能发展为痴呆，应定期评估其认知状态。可以定期进行MMSE测试以检测MCI发展的早期阶段。此外，为了减少认知障碍向痴呆的进展，重视血糖控制和整体糖尿病管理是值得的。
