Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China; Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China.
Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China.
J Formos Med Assoc. 2023 Jul;122(7):603-611. doi: 10.1016/j.jfma.2022.10.008. Epub 2022 Nov 3.
The aim of this study was to determine whether cognitive function is associated with future falls in older patients with diabetes mellitus (DM) compared with those without DM. Cognitive function was divided into several domains to further analyze.
A total of 678 individuals met the inclusion criteria and comprised the final study population. The mean age was 74.35 ± 5.35 years, and 58.9% of the participants were female (n = 400). At the baseline, cognitive function was measured by the Mini Mental State Examination (MMSE), and DM diagnoses were determined by medical records. The self-reported any falls data were obtained via face-to-face questioning at the 1-year follow-up.
At baseline, 15.6% of participants (n = 106) were diagnosed with DM. According to whether they had any falls during 1-year follow-up, there was a significant difference between the two group in fasting plasma glucose (p = 0.012) and DM (p = 0.036) at baseline. Among the older adults with DM, those who had experienced any falls had poorer cognitive function (p = 0.014). After adjusting for various covariates, we found that MMSE (95% CI 0.790-0.991, p = 0.034), orientation to place (95% CI 0.307-0.911, p = 0.022) and registration (95% CI 0.162-0.768, p = 0.009) were significantly associated with falls in the follow-up.
Our study found that in patients with DM, cognitive function is related to future falls. Not only overall cognitive function, but also orientation to place and registration were all associated with future falls in older adults with DM. When completing the fall risk assessment of elderly patients with DM, clinicians should give more attention to the testing of cognitive function.
本研究旨在确定与无糖尿病（DM）的患者相比，认知功能是否与老年糖尿病患者未来的跌倒有关。将认知功能分为几个领域进行进一步分析。
共有 678 人符合纳入标准，构成最终研究人群。平均年龄为 74.35±5.35 岁，58.9%的参与者为女性（n=400）。在基线时，通过简易精神状态检查（MMSE）测量认知功能，通过病历确定 DM 诊断。通过在 1 年随访时的面对面询问获得自我报告的任何跌倒数据。
在基线时，15.6%的参与者（n=106）被诊断患有 DM。根据他们在 1 年随访期间是否有任何跌倒，两组在空腹血糖（p=0.012）和 DM（p=0.036）方面存在显著差异。在患有 DM 的老年人中，有过任何跌倒的人认知功能较差（p=0.014）。在调整了各种协变量后，我们发现 MMSE（95%置信区间 0.790-0.991，p=0.034）、地点定向（95%置信区间 0.307-0.911，p=0.022）和登记（95%置信区间 0.162-0.768，p=0.009）与随访中的跌倒显著相关。
我们的研究发现，在患有 DM 的患者中，认知功能与未来的跌倒有关。不仅是整体认知功能，地点定向和登记也与老年 DM 患者的未来跌倒有关。在对患有 DM 的老年患者进行跌倒风险评估时，临床医生应更加关注认知功能的测试。
