| Objective In this study,elderly diabetes patients aged 60 to 69 years were taken as subjects to evaluate whether hypoglycemia attack would affect their cognitive function,and to analyze other risk factors that might affect their cognitive function,so as to provide diagnosis and treatment basis and new ideas for early cognitive intervention.Methods From January 2019 to January 2020,a total of 137 patients aged 60 to 69 years old with diabetes who were admitted to the Department of Geriatrics of the Second Hospital of Lanzhou University and 65 non-diabetic patients whose age matched that of the elderly diabetes patients in the Physical Examination Center of our hospital were selected.All subjects met the inclusion criteria.According to the presence of diabetes,patients can be divided into the elderly diabetes group(137 cases)and elderly non-diabetes group(65 cases).According to the presence of history of hypoglycemia,the elderly diabetes group can be divided into groups of hypoglycemia(70 cases)and non hypoglycemia group(67 cases),and use the Montreal Cognitive Assessment Scale(MoCA)to evaluate all cognitive situation of the research subjects.Each group data of MoCA scores were compared,and collected the clinical data of the subjects,including age,sex,duration of diabetes,the education level,history of chronic complications of diabetes,high blood pressure,body mass index(BMI),fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2hPBG),fasting insulin(FINS),2-hour postprandial insulin(2hINS),Homeostasis model assessment of insulin resistance(HOMA-IR),hemoglobin(HbA1c),urea(BUN),serum creatinine(SCr),blood uric acid(UA),alanine aminotransferase(ALT),aspertate aminotransferase(AST),triglycerides(TG),total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL)and whether hypoglycemia has occurred,hypoglycemia frequency,severity,etc.SPSS 23.0 statistical software was used to process and analyze all the data collected above,and the continuous variables are expressed as mean ± standard deviation(?x±s),the classified information is expressed as a percentage(%).Independent sample t test and chi-square test were used to compare the data between groups.and multivariate logistic regression was used to analyze the risk factors that may affect the cognitive function of elderly patients with diabetes.The difference was statistically significant(P<0.05).Results(1)The general results: Among the selected 202 cases,137 cases of elderly diabetes patients and 65 cases of elderly non-diabetic patients.There were 70 hypoglycemia patients and 67 non-hypoglycemia patients in the diabetes group.Hypoglycemia group,non-hypoglycemia group and non-diabetes group average age were: 64.09±4.52 years,64.04±4.55 years old,63.46±3.06 years of age,the education lever were: 11.51±2.95 years,12.34±2.90 years,11.51±2.88 years,MoCA scores were: 25.21±1.24 points,26.06±1.20 points,26.25±1.09 points.(2)Study on cognitive function of elderly diabetic patients: 65 cases of elderly non-diabetic patients were included.Compared with the elderly diabetes group(137 cases),the FPG in the diabetes group was higher than that in the non-diabetes group,and the MoCA scores were lower than that in the non-diabetes group,with statistically significant differences(P<0.05).(3)Study on hypoglycemia and cognitive function in elderly diabetic patients: Analysis of 137 elderly patients with diabetes,MoCA scores of hypoglycemia group were lower than that of non-hypoglycemia group(25.21±1.24 points vs 26.06±1.20 points),with statistically significant differences(P<0.05);The incidence of cognitive dysfunction in the hypoglycemia group was 61.4%,significantly higher than that in the non-hypoglycemia group(31.3%),and the difference was statistically significant(P<0.05);According to the frequency and severity of hypoglycemia,the incidence of cognitive impairment in each group was statistically significant(P<0.05).Moreover,the more severe hypoglycemia was,the higher incidence of cognitive impairment was.(4)The influencing factors of cognitive dysfunction in elderly diabetic patients: Whether the elderly with diabetes have cognitive dysfunction(MoCA<26 was defined as 1,and MoCA?26 was defined as 0)as the dependent variable,multivariate logistic regression analysis was performed.Analysis results showed that after adjusting for age,gender,diabetes course,education level,diabetes complications,HbA1 c,HOMA-IR,TC,TG and other factors,hypoglycemia was also an independent risk factor for the occurrence of cognitive dysfunction(OR=3.628,95%CI:1.565~8.409,P<0.05),and the risk of cognitive impairment increased with the increasing frequency and severity of hypoglycemia.Conclusion(1)Older people with diabetes have poorer cognitive function than those with normal glucose metabolism.(2)Among elderly diabetic patients,hypoglycemia patients had poorer cognitive function.(3)Hypoglycemia is an independent risk factor for cognitive dysfunction in elderly diabetic patients.The risk of cognitive impairment increased with the increasing frequency and severity of hypoglycemia. |
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