Alshaikh Alshaymaa A, Alatawi Hind S, Alzahrani Abdullah M
Department of Family Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
Department of Family Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
J Family Med Prim Care. 2021 Oct;10(10):3803-3814. doi: 10.4103/jfmpc.jfmpc_423_21. Epub 2021 Nov 5.
Identification of modifiable risk factors of neurocognitive dysfunction (NCDs) that would help in preventing neurocognitive dysfunction by means of appropriate measures.
The study aims to provide an insight into the extent and cofactors ofNCDs among Saudi type II diabetes (T2DM) patients at the primary care level.
A cross-sectional study was conducted at five randomly selected primary health care centers (PHCCs) of Jeddah, Saudi Arabia.
T2DM patients above 40 years, who were followed for T2DM diagnosed ≥ 1 year ago were recruited. The Arabic version of the Mini-Mental State Evaluation (MMSE) was used for screening NCDs, using education-adjusted cut-offs.
Sociodemographic, diabetes-related, and other clinical and lifestyle factors were analyzed as cofactors of NCDs.
The study included 236 T2DM patients, who had mean ± SD age of 60.29 ± 9.45 years. The majority (61.0%) were female, and mean ± SD duration of T2DM was 14.1 ± 8.4 years (range = 1-45 years). The prevalence of NCDs was 35.2% (95% CI = 29.1%, 41.6%), and 5.1% of the participants had MMSE scores ≤ 10 indicating severe neurocognitive impairment. The congruence of significant sociodemographic factors delineated a high-risk profile, and multivariate regression analysis showed female gender, low educational level, longer duration of diabetes, geriatric age at T2DM diagnosis, inadequate glycemic control, and sedentary lifestyle as the independent risk factors for NCDs.
The population of middle-aged and older T2DM patients is highly exposed to NCDs, with the great contribution of other comorbidities and higher risk incurred by older, lowly educated females with long diabetes duration. Further improvements should be achieved to enhance the care offered to diabetic patients by improving glycemic control, screening for comorbidities, and early detection of neurocognitive decline.
识别可改变的神经认知功能障碍（NCDs）风险因素，这有助于通过适当措施预防神经认知功能障碍。
本研究旨在深入了解沙特初级保健水平的2型糖尿病（T2DM）患者中NCDs的程度和相关因素。
在沙特阿拉伯吉达随机选择的五个初级卫生保健中心（PHCCs）进行了一项横断面研究。
招募40岁以上、确诊T2DM且随访时间≥1年的T2DM患者。使用经教育程度调整的临界值，采用阿拉伯语版简易精神状态检查表（MMSE）筛查NCDs。
分析社会人口统计学、糖尿病相关以及其他临床和生活方式因素作为NCDs的相关因素。
该研究纳入了236例T2DM患者，其平均年龄±标准差为60.29±9.45岁。大多数（61.0%）为女性，T2DM的平均病程±标准差为14.1±8.4年（范围=1 - 45年）。NCDs的患病率为35.2%（95%置信区间=29.1%，41.6%），5.1%的参与者MMSE评分≤10，表明存在严重神经认知障碍。显著社会人口统计学因素的一致性描绘出一个高风险特征，多因素回归分析显示女性、低教育水平、糖尿病病程较长、T2DM诊断时年龄较大、血糖控制不佳以及久坐不动的生活方式是NCDs的独立风险因素。
中老年T2DM患者群体极易患NCDs，其他合并症的影响很大，且年龄较大、受教育程度低、糖尿病病程长的女性风险更高。应通过改善血糖控制、筛查合并症以及早期发现神经认知衰退，进一步提高对糖尿病患者的护理水平。
