Cognitive Impairment among Type 2 Diabetes Mellitus Patients at Jimma University Specialized Hospital, Southwest Ethiopia; Comparative Cross Sectional Study

Abstract

Background: Diabetes mellitus (DM) is a chronic disorder caused by deficiency of insulin, which affects functions of the brain, kidneys, vision and other organs. Cognitive impairment is the major public health problem worldwide particularly in elderly people with type 2 DM. But, little is known about the net association between DM and cognitive impairment among adults. Objective: The aim of the present study was to determine magnitude of cognitive impairment and associated factors among patients with T2DM in Jimma University Specialized Hospital, 2016. Methods: Comparative cross sectional study was employed among 105 patients with T2DM, who were under follow-up in DM clinic and 105 age, sex and educational level matched healthy individuals coming to the clinic by using consecutive sampling technique. The tool contained 30- point standardized mini-mental state examination, sociodemographic, substance use and clinical archives. Descriptive statistics were done. Moreover, Chi-square test, independent t-test, and logistic regression were carried out and variables with p<0.05 were considered as significant. Results: The prevalence of cognitive impairment in DM was 53.3% and in healthy controls it was 31.4%. Diabetics were 2.5 times more risky than healthy controls [OR=2.49, 95% CI (1.42, 4.38)] for cognitive impairment. DM patients who had fasting blood glucose (FBG) ≥126mg/dl were 4.4 times [AOR=4.43, 95% CI (1.14, 17.18)] more likely to have cognitive impairment than those who had FBG˂ 126 mg/dl. DM patients who relied on only oral hypoglycemic agents were 5.4 times higher than those using insulin only [AOR=5.39, 95% CI (1.37, 41.18)] to have cognitive impairment. DM patients aged ≥62 years had 7.5 times [AOR= 7.54, 95% CI (1.38, 41.38)] risk for cognitive impairment than those ≤ 45 years. Conclusion: The prevalence of cognitive impairment among T2DM patients was significantly higher than healthy controls. Hyperglycemic state could lead to neuronal damage via direct toxic effect and/or free radical formation which might be worsened in the elderly and those who relied on oral hypoglycemic agents only. This emphasized the need to integrate screening and management options of cognitive impairment among T2DM patients as part of routine activity and awareness creation.