Prevalence Study Of Mild Cognitive Impairment In Hospitalized Patients With Type Ⅱ Diabetes Mellitus

Objectives: To evaluate the status of mild cognitive impairment(MCI)in hospitalized patients with type 2 diabetes mellitus(T2DM)and systematically explore the potential determinants of the prevalence of MCI in hospitalized patients with T2 DM.Methods: This study was cross-sectional.T2 DM patients who were hospitalized in the endocrinology department of a tertiary hospital in Changsha City,Hunan Province from March to December 2021 were selected as the study subjects.The general demographic characteristics,lifestyle and behavior characteristics and disease-related characteristics of T2 DM patients were collected by the self-developed questionnaire.Social Support Rate Score,Medical Coping Modes Questionnaire and Hospital Anxiety and Depression Scale were used to evaluate the level of social support,coping style and anxiety and depression emotional state of T2 DM patients.The cognitive function of T2 DM patients was measured with the Mini-Mental State Examination.Multivariable logistic regression analyses were performed to explore the factors that contributed to the prevalence of MCI outcomes.Path analyses were used to analyze the potential interaction.Statistical analyses were conducted using SPSS24.0 and Amos 24.0.Results:(1)General information: A total of 496 valid questionnaires were collected in this study.Among the 496 subjects,284(57.3%)were male and 212(42.7%)were female.The mean age at admission was59.57±9.92 years.(2)Prevalence of MCI: Among 496 T2 DM patients,169 had MCI,327 had normal cognitive function,and the prevalence of MCI was34.10%(95%CI: 29.89%-38.26%).(3)Multivariable logistic regression analyses: Compared with the40～ group,the 60～ group(OR=4.566,95% CI: 2.811-7.417)and the ≥80group(OR=17.297,95%CI: 3.931-76.119)were positively correlated with the prevalence of MCI in hospitalized T2 DM patients(P<0.05);Compared with the group with per capita monthly household income of0-2,000 yuan in the last year,the group of more than 5000 yuan(OR=0.373,95%CI: 0.193-0.719)was negatively correlated with prevalence of MCI in hospitalized T2 DM patients(P<0.05);Diabetic nephropathy(OR=1.782,95%CI: 1.061-2.806),diabetic retinopathy(OR=1.782,95%CI : 1.088-2.918),anxiety(OR=3.522,95%CI:1.914-6.480)and depression(OR=2.194,95%CI: 1.232-3.906)were positively correlated with prevalence of MCI in hospitalized T2 DM patients,while more optimistic coping style(OR=0.933,95%CI:0.880-0.988)was negatively correlated with prevalence of MCI in hospitalized T2 DM patients(P<0.05).(4)Path analyses: The standardized direct effect,standardized indirect effect,and standardized total effect of objective support on cognitive function were 0.119,0.055,and 0.174,respectively;the standardized direct effect,standardized indirect effect,and standardized total effect of optimistic coping style on cognitive function were 0.094,0.011,and 0.105,respectively;subjective support,support utilization,and submissive coping style have only indirect effects on cognitive function,and the standardized indirect effects are 0.094,0.118,and-0.322,respectively.Conclusions:(1)The prevalence of MCI in hospitalized patients with T2 DM was34.10%(95%CI: 29.89%-38.26%).(2)Older age(compared with 40～ group),diabetic nephropathy,diabetic retinopathy,anxiety,and depression were negatively correlated with prevalence of MCI in hospitalized T2 DM patients;Per capita monthly household income of more than 5000-yuan last year(compared with 0 yuan ～ 2,000 yuan),more optimistic coping style were positively correlated with the prevalence of MCI in hospitalized T2 DM patients.(3)There were significant correlations between social support,medical coping style,anxiety and depression,and cognitive function;Optimistic coping style,submissive coping style,anxiety and depression played a mediating role in the effect of social support on cognitive function.