Correlation Between Anxiety,depression And Cognitive Dysfunctiont In Elderly Patients With Type 2 Diabetes Mellitus

Objective:explore the correlation between anxiety,depression and cognitive impairment in elderly patients with type 2 diabetes mellitus(T2DM),so as to provide theoretical basis for early screening and early intervention of elderly T2DM。Materials and methods:From October 2019 to October 2020,160 T2 DM patients aged 65 years or above admitted to the Department of Endocrinology,Affiliated Hospital of Chengde Medical College were randomly selected as subjects.All subjects underwent 14 items of Hamilton Anxiety Scale(HAMA)and 24 items of Hamilton Depression Scale(HAMD),According to the results,they were divided into simple elderly T2 DM group(control group),elderly T2 DM with anxiety group,elderly T2 DM with depression group,elderly T2 DM with anxiety and depression group.The age,gender,smoking history,drinking history,body mass index(BMI),systolic pressure(SBP),diastolic pressure(DBP)of all subjects were collected,General clinical data,such as DBP,course of disease,years of education,bone mineral density(BMD),complications(hypertension,coronary heart disease,etc.),and glycosylated hemoglobin(Hb A1c),fast blood glucose(FPG),uric acid(UA),total cholesterol(TC),triglyceride(TG),etc,TG,low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and other biochemical indicators.At the same time,Montreal Cognitive Assessment(Mo CA)was used to evaluate the cognitive score of patients in each group,The incidence of anxiety and depression was analyzed.All data were processed by IBM SPSS 25.0 statistical software.The differences of baseline data and cognitive function among the groups were compared.The correlation between MOCA corrected total score and HAMA score,HRSD score,and the correlation between BMD and MOCA score were discussed.The related factors influencing cognitive function of elderly patients with T2DM were analyzed.Results:1.The incidence of anxiety and depression in elderly patients with T2 DM,including 34 cases of simple elderly patients with T2 DM,the incidence rate was 21.25%.16 cases with simple anxiety,the incidence rate was 10%.38 cases with simple depression,the incidence rate was 23.75%.72 cases with anxiety and depression,The incidence rate was was 45%.2.Comparing the baseline data of the four groups,the results showed that there were no significant differences in age,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),blood lipids,diabetes duration,complications and other aspects among the four groups(P > 0.05);there were significant differences in glycosylated hemoglobin(Hb A1c),HAMA score,HRSD score,MOCA score and other aspects among the four groups(P < 0.05)。3.The results of LSD-t test showed that the MOCA score of elderly T2 DM patients with anxiety and / or depression was significantly lower than that of simple T2 DM patients.Compared with elderly T2 DM patients with simple anxiety or depression,patients with anxiety and depression had lower MOCA score.4.Pearson correlation analysis showed that HAMA score was negatively correlated with MOCA score in elderly patients with T2DM(r =-0.885,P < 0.001);HRSD score was negatively correlated with MOCA score(r =-0.895,P < 0.001).5.Univariate analysis showed that the MOCA corrected total score of elderly patients with T2 DM was negatively correlated with FPG,Hb A1 c,HAMA score and HRSD score,and the difference was statistically significant(P < 0.05).There was a positive correlation between BMI and education years,UA(P < 0.05),but no significant correlation with BMI(P >0.05);6.Multiple linear regression equation showed that after adjusting for FPG,Hb A1 c,years of education,UA and other factors that may affect cognitive function,anxiety and depression scores were still negatively correlated with cognitive function scores(b1 =-0.298,b2 =-0.378;P <0.001).7.Correlation analysis showed that there was a significant positive correlation between BMD value and MOCA adjusted total score(r = 0.602,P< 0.001).After single factor screening,BMD was included in multiple linear regression equation.After adjusting for FPG,Hb A1 c,years of education,UA and other factors,BMD was still independently correlated with MOCA score(b= 0.229,P < 0.001).Conclusion:1.The incidence of anxiety and depression is high in elderly patients with T2 DM,and anxiety and depression often exist together.2.The cognitive function of elderly patients with T2 DM complicated with anxiety and / or depression was significantly impaired;the cognitive function of elderly patients with T2 DM combined with anxiety and depression was more significantly impaired.The scores of anxiety and depression were negatively correlated with the scores of cognitive function.Anxiety,depression and other emotions are independent risk factors of cognitive dysfunction in elderly patients with T2 DM.3.FPG,Hb A1c,anxiety and depression are important risk factors of cognitive dysfunction in elderly patients with T2 DM,while BMD,years of education and UA are important protective factors of cognitive dysfunction in elderly patients with T2DM.