Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico.
Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15. CP 14080, Tlalpan, Mexico City, Mexico.
BMC Geriatr. 2020 Sep 22;20(1):363. doi: 10.1186/s12877-020-01776-5.
The type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D. T2D-related factors have been shown increase the risk of age-related conditions, which might also increase dementia risk. Here, we investigate the associations of DSDRS with frailty, disability, quality of life (QoL) and cognition in community-dwelling older adults with T2D.
We included 257 community-dwelling older adults with T2D to evaluate the association between DSDRS and Mini-mental state examination (MMSE), Isaac's set-test (IST), clock drawing test (CDT), quality of life (SF-36), risk of malnutrition (Mini-Nutritional Assessment or MNA), as well as frailty, Katz' and Lawton-Brody scores. We also assessed the phenotype and correlates of high-estimated dementia risk by assessing individuals with DSDRS >75th age-specific percentiles.
Mean age of participants was 78.0 ± 6.2 years. DSDRS showed a significant correlation with MMSE test, IST, CDT, SF-36, MNA, Lawton-Brody and Katz scores, and an increasing number of frailty components. DSDRS was higher among frail, pre-frail, and subjects with limited ADL and IADL (p < 0.001). Participants with DSDRS >75th age-specific percentiles had lower education, MMSE, IST, SF-36, MNA, Katz, Lawton-Brody, and higher frailty scores. High-estimated 10-year dementia risk was associated with ADL and IADL disability, frailty and risk of malnutrition. When assessing individual components of DSDRS, T2D-related microvascular complications were associated to all outcome measures.
The DSDRS is associated with frailty, disability, malnutrition and lower cognitive performance. These findings support that T2D-related factors have significant burden on functional status, QoL, disability and dementia risk.
2 型糖尿病（T2D）特异性痴呆风险评分（DSDRS）旨在评估患有 T2D 的老年患者的痴呆风险。已经表明，T2D 相关因素会增加与年龄相关的疾病风险，这也可能会增加痴呆风险。在这里，我们研究了 DSDRS 与社区居住的 T2D 老年患者的虚弱、残疾、生活质量（QoL）和认知之间的关系。
我们纳入了 257 名社区居住的 T2D 老年患者，以评估 DSDRS 与简易精神状态检查（MMSE）、艾萨克设定测试（IST）、时钟绘制测试（CDT）、生活质量（SF-36）、营养不良风险（微型营养评估或 MNA）以及虚弱、Katz 和 Lawton-Brody 评分之间的关系。我们还评估了通过评估 DSDRS>75 岁特定百分位数的个体来评估高估计痴呆风险的表型和相关性。
参与者的平均年龄为 78.0±6.2 岁。DSDRS 与 MMSE 测试、IST、CDT、SF-36、MNA、Lawton-Brody 和 Katz 评分以及虚弱成分数量呈显著相关。虚弱、衰弱前期和日常生活活动（ADL）和日常生活活动（IADL）受限的患者 DSDRS 较高（p<0.001）。DSDRS>75 岁特定百分位数的参与者受教育程度较低，MMSE、IST、SF-36、MNA、Katz、Lawton-Brody 评分较低，虚弱评分较高。高估计的 10 年痴呆风险与 ADL 和 IADL 残疾、虚弱和营养不良风险相关。在评估 DSDRS 的个体成分时，T2D 相关的微血管并发症与所有结局指标相关。
DSDRS 与虚弱、残疾、营养不良和认知能力下降有关。这些发现支持 T2D 相关因素对功能状态、生活质量、残疾和痴呆风险有重大影响。
