The Prevalence And Screening Tool Of Cognition In Patients With Type2Diabetes

Objectives: To descript the composition of patients with cognitiveimpairment in type2diabetes mellitus (T2DM) patients and analysis ofcognitive function in them, to explore the risky factors that affectingcognitive function. Further by analysising correlation and sensitivity ofMontreal Cognitive Assessment (MoCA) and Mini-mental stateexamination (MMSE) in cognitive dysfunction screening, to provideclinical basis for the early diagnosis and prevention of dementia.Methods: A5-month-long (Oct.18th,2011-Mar.13th,2012)cross-sectional study of203over-50-year-old T2DM patients in Outpatientand Inpatient of Department of Neurology and Endocrinology of The FirstAffiliated Hospital of Chongqing Medical University. T2DM patients arefirstly investigated face-to-face with a self-designed questionnaire,including general demographic data, history of chronic disease, diabetes,cognitive impairment and other related symptoms. Secondly, all thesepatients are screened by laboratory tests (fasting blood glucose,glycosylated hemoglobin A1c) and evaluated their cognitive function byadopting Montreal Cognitive Assessment (MoCA) scale (Chinese version) and Mini-mental State Examination (MMSE). Finally, data are recordedand analyzed with SPSS19.0statistical software.Results:203T2DM patients with the score of MoCA and MMSEwere21.20±4.39points and26.89±2.85points respectively.The MoCA scores were26-30（normal range，NC） in22patients(10.8%), and≤25（definite CI） in181(89.2%). The MMSE scores were28-30（normal range,NC） in107patients （52.7%）,25-27（suspectedCI）in78（38.4%）, and18patients (8.9%) were checked out with MMSEbelow the boundary (definite CI，dCI). As a result, score for MoCA ismarkedly lower than score for MMSE. Their differences have remarkablestatistics meaning(Z=-11.976，P<0.001). Scores for MoCA and for MMSEare interrelated(r=0.524，P<0.001).Most T2DM patients have correlative symptoms of cognitivedysfunction, of which152cases (75.24%) patients have subjectivehypomnesis. In the cognitive function screening of the normal andimpairment, the average levers of patients with cognitive impairment ineach item of cognitive function screening are lower. Besides, there isstatistically significance in studying the differences in items (visual space,executive function, object naming, attention, delayed recall) betweenpatients of normal and impairment. In multiple linear regression analysis,regression coefficient is0.497for educational length,-0.179for age and-0.366for HbA1c. P＜0.05, which therefore is of statistically significance. Conclusions: The T2DM patients are with higher morbidity thanordinary people in CI and the morbidity is related to education years, age,HbA1c and other factors. The sensitivity of MoCA is higher than MMSE inthe screening of CI, so we suggest to use MoCA to screen high-risk T2DMpatients in order to early detection of cognitive impairment.