Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetes
Background and Aims: With the world’s aging population, twin epidemics of type-2 diabetes (T2D) and dementia take a great toll on the healthcare burden. T2D carries a 2–3 times greater risk of developing cognitive impairment than controls. Early identification of cognitive impairment is important as...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-06-01
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| Series: | Journal of Family Medicine and Primary Care |
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| Online Access: | https://journals.lww.com/10.4103/jfmpc.jfmpc_1900_24 |
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| author | Subhankar Chatterjee Rana Bhattacharjee Anirban Sinha Animesh Maiti Anustup Mukherjee Ritwik Ghosh Souvik Dubey |
| author_facet | Subhankar Chatterjee Rana Bhattacharjee Anirban Sinha Animesh Maiti Anustup Mukherjee Ritwik Ghosh Souvik Dubey |
| author_sort | Subhankar Chatterjee |
| collection | DOAJ |
| description | Background and Aims:
With the world’s aging population, twin epidemics of type-2 diabetes (T2D) and dementia take a great toll on the healthcare burden. T2D carries a 2–3 times greater risk of developing cognitive impairment than controls. Early identification of cognitive impairment is important as it impairs diabetes self-management, making patients prone to complications. However, data about the assessment of cognitive impairment in T2D using a comprehensive cognitive battery is sparse in India. This study was undertaken to estimate the prevalence and pattern of cognitive impairment among young and middle-aged patients with T2D.
Materials and Methods:
A cross-sectional observational study was conducted in a tertiary care teaching hospital in Kolkata (2022–2024) among 125 Bengali-speaking T2D patients with formal education > class IV, aged between 20 and 60 years. The cognitive evaluation was done using the clinical dementia rating scale, mini-mental status examination (MMSE), Montreal cognitive assessment (MoCA), and Addenbrooke’s cognitive examination (ACE)-III. Statistical analyses were done by Jeffrey’s Amazing Statistics Program version 0.19 with appropriate tests (Chi-squared test, Mann–Whitney U test, Spearman correlation statistics, and logistic regression). P value < 0.05 was considered significant.
Results:
T2D patients reported a more subjective sensation of forgetfulness compared to the control group (P = 0.001). MMSE was an insufficient screening tool to distinguish between these two groups. On MoCA and ACE-III, there was a significant difference in total scores between case and control groups (MoCA, P = 0.012 and ACE-III, P < 0.001). Based on ACE-III, 59.20% of T2D patients had cognitive impairment (P < 0.001). The odds of having cognitive impairment in T2D were 3.72 times higher than in the control group (P < 0.001). There was significant impairment of memory (P < 0.001), fluency (P = 0.020), and visuospatial ability (P = 0.032). Females (P = 0.010), less education (P < 0.001), lower socioeconomic status (P < 0.001), BMI < 23 kg/m2 (P = 0.049), peripheral neuropathy (P = 0.001), hypothyroidism (P = 0.007), anxiety (P < 0.001), and depression (P < 0.001) were significantly associated with cognitive impairment in diabetes.
Conclusion:
This is the first study from Eastern India to use a comprehensive cognitive scale validated in the local vernacular. Cognitive impairment is prevalent among a significant portion of middle-aged, educated individuals with T2D. Cognitive evaluation should be incorporated into diabetes management from the onset, with a focus on addressing modifiable factors. |
| format | Article |
| id | doaj-art-20abcd0629bb4f569849dda0527ed9ef |
| institution | DOAJ |
| issn | 2249-4863 2278-7135 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj-art-20abcd0629bb4f569849dda0527ed9ef2025-08-20T03:15:39ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632278-71352025-06-011462527253710.4103/jfmpc.jfmpc_1900_24Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetesSubhankar ChatterjeeRana BhattacharjeeAnirban SinhaAnimesh MaitiAnustup MukherjeeRitwik GhoshSouvik DubeyBackground and Aims: With the world’s aging population, twin epidemics of type-2 diabetes (T2D) and dementia take a great toll on the healthcare burden. T2D carries a 2–3 times greater risk of developing cognitive impairment than controls. Early identification of cognitive impairment is important as it impairs diabetes self-management, making patients prone to complications. However, data about the assessment of cognitive impairment in T2D using a comprehensive cognitive battery is sparse in India. This study was undertaken to estimate the prevalence and pattern of cognitive impairment among young and middle-aged patients with T2D. Materials and Methods: A cross-sectional observational study was conducted in a tertiary care teaching hospital in Kolkata (2022–2024) among 125 Bengali-speaking T2D patients with formal education > class IV, aged between 20 and 60 years. The cognitive evaluation was done using the clinical dementia rating scale, mini-mental status examination (MMSE), Montreal cognitive assessment (MoCA), and Addenbrooke’s cognitive examination (ACE)-III. Statistical analyses were done by Jeffrey’s Amazing Statistics Program version 0.19 with appropriate tests (Chi-squared test, Mann–Whitney U test, Spearman correlation statistics, and logistic regression). P value < 0.05 was considered significant. Results: T2D patients reported a more subjective sensation of forgetfulness compared to the control group (P = 0.001). MMSE was an insufficient screening tool to distinguish between these two groups. On MoCA and ACE-III, there was a significant difference in total scores between case and control groups (MoCA, P = 0.012 and ACE-III, P < 0.001). Based on ACE-III, 59.20% of T2D patients had cognitive impairment (P < 0.001). The odds of having cognitive impairment in T2D were 3.72 times higher than in the control group (P < 0.001). There was significant impairment of memory (P < 0.001), fluency (P = 0.020), and visuospatial ability (P = 0.032). Females (P = 0.010), less education (P < 0.001), lower socioeconomic status (P < 0.001), BMI < 23 kg/m2 (P = 0.049), peripheral neuropathy (P = 0.001), hypothyroidism (P = 0.007), anxiety (P < 0.001), and depression (P < 0.001) were significantly associated with cognitive impairment in diabetes. Conclusion: This is the first study from Eastern India to use a comprehensive cognitive scale validated in the local vernacular. Cognitive impairment is prevalent among a significant portion of middle-aged, educated individuals with T2D. Cognitive evaluation should be incorporated into diabetes management from the onset, with a focus on addressing modifiable factors.https://journals.lww.com/10.4103/jfmpc.jfmpc_1900_24cognitioncognitivedementiadiabetesexecutive dysfunctionmemorymild cognitive impairment |
| spellingShingle | Subhankar Chatterjee Rana Bhattacharjee Anirban Sinha Animesh Maiti Anustup Mukherjee Ritwik Ghosh Souvik Dubey Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetes Journal of Family Medicine and Primary Care cognition cognitive dementia diabetes executive dysfunction memory mild cognitive impairment |
| title | Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetes |
| title_full | Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetes |
| title_fullStr | Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetes |
| title_full_unstemmed | Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetes |
| title_short | Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetes |
| title_sort | prevalence and pattern of cognitive dysfunction in young adults and middle aged patients with type 2 diabetes |
| topic | cognition cognitive dementia diabetes executive dysfunction memory mild cognitive impairment |
| url | https://journals.lww.com/10.4103/jfmpc.jfmpc_1900_24 |
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