Risk of mini-mental state examination (MMSE) decline in the elderly with type 2 diabetes: a Chinese community-based coho
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RESEARCH ARTICLE
Open Access
Risk of mini-mental state examination (MMSE) decline in the elderly with type 2 diabetes: a Chinese community-based cohort study Lei Zhao1, Chao Han2, Zheng Zheng2, Shuang Ling Xiu1 and Piu Chan3,4,5,6,7,8*
Abstract Background: We aimed to investigate the correlation of factors involved in the change of Mini-Mental State Examination (MMSE) and type 2 diabetes in the elderly. Methods: This study was a secondary analysis of a prospective cohort study. Type 2 diabetes patients aged > 55 years were recruited and assigned into three groups based on their glycated hemoglobin (HbA1c) levels: HbA1c < 7, 7% ≤ HbA1c < 8% and HbA1c ≥8%. MMSE decline was considered the endpoint. Factors related to MMSE decline were identified by univariate and multivariate regression analyses. Results: Altogether, 1519 subjects were included, 883 in the Low group, 333 in the Median group, and 303 in the High group. Age ≥ 75 years, education below elementary school level, not participating in seminars or consultation on healthcare, physical activity less than 30 min/day, cerebrovascular disease history, MMSE score at baseline, and HBA1c ≥8% were associated with cognitive decline by univariate and multivariate analysis. When the other factors were adjusted for, HBA1c ≥8% was independently associated with the severity of cognitive decline (β = 0.58, 95%CI: 0.06–1.11, P = 0.029) and the occurrence of cognitive decline (odds ratio (OR) = 1.55, 95%CI:1.13–2.12, P = 0.007). Conclusions: In elderly patients with type 2 diabetes, HbA1c ≥8% is an independent factor for cognitive decline and is also associated with the severity of the cognitive decline. Keywords: Diabetes mellitus, Type 2, Cognitive dysfunction, Aged, Glycated hemoglobin a, Risk factors
Background The number of people with diabetes mellitus is increasing rapidly and has more than doubled globally in thirty years, making it a major public health challenge for all nations [1]. Around 90% of cases of diabetes are type 2 diabetes mellitus (T2DM), and this is particularly important in China, which is an epicenter for the global * Correspondence: [email protected] 3 Department of Neurobiology, Geriatrics, and Neurology, Xuanwu Hospital, No. 45 Changchun St., Xicheng District, Beijing, China 4 Department of Neurology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing 100053, China Full list of author information is available at the end of the article
T2DM epidemic [2]. T2DM is associated with a wide range of complications, including cardiac diseases, diabetic foot, and diabetic nephropathy [3]. However, the adverse impact of T2DM is not limited to these common diseases, and it is also associated with exacerbation of age-related decline in physical and cognitive function [4]. Individuals with T2DM score less well on cognitive function tests such as the Mini-Mental State Examination (MMSE) than those without diabetes [5], and a clear relationship between diabetes in midlife and greater cognitive decline has been demonstrated
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