Characteristics Of Mild Cognitive Impairment And Related Risks In Patient With Type 2 Diabetes Mellitus

Objective:To investigate the characteristics and the related risk factors of mild cognitive impairment in patients with type 2 diabetes. To give a preliminary discussion about the application value of the revised Chinese version of the Addenbrooke's cognitive examination-? in patients with type 2 diabetes.Methods:We collected 18 T2 DM cases with no cognitive impairment(T2DM-NCI group)and 40 T2 DM cases with mild cognitive impairment(T2DM-MCI group) who met the inclusion criteria. Mini-mental State Examination(MMSE),Montreal Cognitive Assessment(Mo CA),the revised Chinese version of the Addenbrooke's cognitive examination- ? and 7 cognitive tests covering 5 cognitive domains were used to assess the cognitive function of the subjects.We collected related information that may effect the cognitive function of the patients with T2 DM,including basic demographic characteristics,lifestyle,the clinical features of T2 DM and relevant test indicators.The factors which existed difference between two groups were anlysed by the logistic regression to control for confounding factors and to find the risk factors for cognitive impairment in patients with T2 DM.Meanwhile we computed the odds ratios and the 95% confidence intervals.Results:1. The T2DM-MCI group scored lower in the MMSE?Mo CA?ACE-? tests( p<0.05) and in visual space/executive function sub-item,language/naming/abstaction sub-item,attention sub-item, orientation sub-item of Mo CA,the difference was significant(p<0.05). In the single test of cognitive domain including executive function, visuospatial skills,memory,information processing speed and language,the T2DM-MCI group also performed worse than the T2DM-NCI group(p<0.05).2. The p\atients with amnestic mild cognitive impairment accounted for 45% of the T2DM-MCI group.There was no difference between the a MCI group and the na MCI group in the cognitive domain of executive function, visuospatial skills,language/naming/abstraction,attention and orientation(p>0.05).3.The Cronbach's a of the Chinese version of ACE- ? is 0.768;The correlation coefficient between ACE- ? and Mo CA is 0.768(p<0.001).The area under the ROC curve for ACE- ? was 0.906(0.827, 0.985).The T2DM-MCI group got a lower score in the sub-item of attention/orientation,memory,verbal fluency,language and visual space of ACE- ? compared to the T2DM-NCI group,the difference was statistically significant(p<0.01).4.The potential risk factors were compared between two groups,among which the age, years of education,average sleeping time, diabetic retinopathy, Lp(a) level had statistical significance.After adjustment for confounders, age and average sleeping time remained associated with mild cognitive impairment in T2 DM patient,the ORs(95%CIs) were 1.310(1.045~1.645) and 0.205(0.049~0.860) respectively.Conclusions:1.The general cognitive function and the single cognitive cognitive domain of memory,attention,executive function/information processed speed,visual space and language of patients with T2 DM were impaired to a different degree.The patients of a MCI accounted for 45% of the MCI patients with T2 DM.2.Mo CA was more sensitive than MMSE to find cognitive impairment in T2 DM patients.Both Mo CA and cognitive test sets consisting of 7 tests on five single cognitive domains could reflect the characteristics of the mild cognitive impairment in patients with T2 DM more exactly.3. The Chinese version of ACE-? had good internal consistency reliability,and it coud effectively detect impairment of general cognitive function and single cognitive domains.4. Advanced age,less education years, diabetic retinopathy,less average sleeping time and high level of LP(a) were risk factors of cognitive impairment in patients with T2 DM,and advanced age and less average sleeping time were independent risk factors.