Xu Weiran, Hu Xiling, Zhang Xing, Ling Cong, Wang Chaofan, Gao Lingling
School of Nursing, Sun Yat-sen University, Guangzhou, People's Republic of China.
Department of Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Oct 28;14:4361-4369. doi: 10.2147/DMSO.S333373. eCollection 2021.
This study investigated the biomedical, psychological, and social behavior risk factors for cognitive impairment in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM).
This cross-sectional study included 240 patients with T2DM. A questionnaire was used to collect demographic and disease-related data on patients, and the Self-rating Depression Scale (SDS), Diabetes Self-care Scale (DSCS), and Social Support Rating Scale (SSRS) were used to assess patients' depression status, self-management behavior, and social support, respectively. The Chinese version of the Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive function, with a score <26 set as the threshold for cognitive impairment.
The prevalence of cognitive dysfunction in middle-aged and elderly patients with T2DM was 52.5%. Multivariate logistic regression analysis showed that older age, a history of hypoglycemia within 1 month, and depression were independent risk factors for cognitive impairment. Education for >12 years, urban living, and a higher total score on the DSCS were independent protective factors against cognitive impairment.
T2DM patients with high risk of cognitive impairment can be identified early from the bio-psycho-social perspective. Patients with T2DM who are older, less educated, living in rural areas, have hypoglycemia history, and have poor self-management of diabetes are at increased risk of cognitive impairment. Closer monitoring of patients with hypoglycemia, early detection of depression, and improving patients' self-management capacity can prevent cognitive impairment in middle-aged and elderly patients with T2DM.
本研究调查了中老年2型糖尿病（T2DM）患者认知障碍的生物医学、心理和社会行为风险因素。
这项横断面研究纳入了240例T2DM患者。使用问卷收集患者的人口统计学和疾病相关数据，并分别使用自评抑郁量表（SDS）、糖尿病自我管理量表（DSCS）和社会支持评定量表（SSRS）评估患者的抑郁状态、自我管理行为和社会支持。采用中文版蒙特利尔认知评估量表（MoCA）评估认知功能，以得分<26分为认知障碍阈值。
中老年T2DM患者认知功能障碍的患病率为52.5%。多因素logistic回归分析显示，年龄较大、1个月内有低血糖史和抑郁是认知障碍的独立危险因素。受教育年限>12年、城市居住以及DSCS总分较高是认知障碍的独立保护因素。
可从生物 - 心理 - 社会角度早期识别认知障碍高风险的T2DM患者。年龄较大、受教育程度较低、居住在农村地区、有低血糖史且糖尿病自我管理较差的T2DM患者认知障碍风险增加。密切监测低血糖患者、早期发现抑郁并提高患者自我管理能力可预防中老年T2DM患者发生认知障碍。
