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| Prediction of cognitive decline among elderly patients with type 2 diabetes mellitus |
| WANG Xiaowei, XU Yanlan
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| Department of Geriatric Medicine, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, China |
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Abstract Objective To predict the risk of cognitive decline among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into the early identification of cognitive decline in elderly patients with T2DM. Methods The elderly patients with T2DM hospitalized in the Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University were selected as subjects. General information was collected by a questionnaire survey, including demographics and nutritional status, and cognitive decline was assessed using the frailty Phenotype Scale, the Montreal Cognitive Assessment and the Clinical Dementia Rating. Multivariable logistic regression model was used to analyze the influencing factors of cognitive decline among elderly patients with T2DM. A nomogram was established, and was verified with Bootstrap resampling method and receiver operation characteristic curve. Results A total of 270 questionnaires were sent out and 262 valid questionnaires were collected, with an effective rate of 97.04%. There were 137 males (52.29%), 146 patients at ages of 60 to 69 years (55.73%), 179 married patients (68.32%), and 85 patients with cognitive decline (32.44%). Multivariable logistic regression analysis identified gender (female, OR=3.118), age (70 to 79 years, OR=3.218; 80 years and older, OR=3.058), educational level (high school or technical secondary school, OR=0.335; junior college, OR=0.130; college and above, OR=0.300), regular exercise (OR=0.083), memory (decreased, OR=29.723), nutritional status (risk of malnutrition, OR=16.307; malnutrition, OR=39.469), activity of daily living (decreased, OR=6.804) and depressive symptoms (OR=8.609) as factors affecting cognitive decline among elderly patients with T2DM (all P<0.05). The nomogram based on the above factors fit well and indicated strong predictive ability. Conclusion Gender, age, educational level, regular exercise, memory, nutritional status, activity of daily living and depressive symptoms can effectively predict the risk of cognitive decline among elderly patients with T2DM.
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Received: 24 July 2023
Revised: 19 October 2023
Published: 15 December 2023
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[1] WON C W,LEE Y,KIM S,et al.Modified criteria for diagnosing "cognitive frailty"[J].Psychiatry Investig,2018,15(9):839-842.
[2] 滑雪娇,闫保云,张乐乐,等.老年2型糖尿病病人认知衰弱现状及影响因素研究[J].蚌埠医学院学报,2023,48(7):985-988,993.
[3] 穆白雪,李铭麟,张成普.老年营养不良与抑郁症的研究进展[J].实用老年医学,2023,37(3):219-222.
[4] 蒋明金,冯天天,姚雪,等.老年2型糖尿病患者认知衰弱危险因素的Logistic回归分析及对执行功能和跌倒恐惧发生风险的影响[J].现代生物医学进展,2022,22(21):4076-4080.
[5] 赵美红,朱瑶蕾,胡美娇,等.衰弱在高龄患者营养与认知功能间的中介效应[J].军事护理,2023,40(3):15-18.
[6] 黄文,李金,陈奇峰.老年人认知功能损害的影响因素分析[J].预防医学,2020,32(11):1130-1133.
[7] FRIED L P,TANGEN C M,WALSTON J,et al.Frailty in older adults:evidence for a phenotype[J].J Gerontol A Biol Sci Med Sci,2001,56(3):146-156.
[8] NASREDDINE Z S,PHILLIPS N A,BÉDIRIAN,et al.The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2010,53(4):695-699.
[9] HUGHES C P,BERG L,DANZIGER W L,et al.A new clinical scale for the staging of dementia[J].Br J Psychiatry,1982,140(6):566-572.
[10] RUBENSTEIN L Z,HARKER J O,SALVÀ A,et al.Screening for undernutrition in geriatric practice:developing the short-form mini-nutritional assessment(MNA-SF)[J].J Gerontol A Biol Sci Med Sci,2001,56(6):366-372.
[11] LAWTON M P,BRODY E M.Assessment of older people:self-maintaining and instrumental activities of daily living[J].Gerontologist,1969,9(3):179-186.
[12] HOYL M T,ALESSI C A,HARKER J O,et al.Development and testing of a five-item version of the geriatric depression scale[J].J Am Geriatr Soc,1999,47(7):873-878.
[13] KELAIDITI E,CESARI M,CANEVELLI M,et al.Cognitive frailty:rational and definition from an(I.A.N.A./I.A.G.G.)international consensus group[J].J Nutr Health Aging,2013,17(9):726-734.
[14] 刘泳秀,韩婷,余莉,等.老年2型糖尿病患者认知衰弱现状及影响因素研究[J].中国慢性病预防与控制,2021,29(6):426-431.
[15] 王飞飞,姚桂英,侯秀珍,等.自我感知老化在社区老年人衰弱和认知功能间的中介作用[J].中华行为医学与脑科学杂志,2023,32(3):250-256.
[16] 朱心红,李傅冬,吴因平.60岁及以上老年人群认知功能障碍及影响因素分析[J].预防医学,2018,30(7):685-687,692.
[17] 龙春鹂,刘芬,赵淑盼.老年糖尿病合并认知衰弱的研究进展[J].中国临床保健杂志,2022,25(1):141-144.
[18] 杨路静,范雪,张旭东.老年轻度认知障碍患者的衰弱现状及影响因素[J].神经损伤与功能重建,2023,18(2):68-71,102.
[19] 钟素亚,仝振东,胡本祥,等.舟山市社区老年人轻度认知功能损害影响因素研究[J].预防医学,2018,30(2):170-172,175.
[20] 司梅,王惠琴,黄云波.低热量饮食干预与有氧运动干预对早期2型糖尿病肥胖患者胰岛素水平及人体成分的影响[J].中国实用护理杂志,2022,38(3):229-234.
[21] 林静静,杜雨珊,梁明斌,等.中老年人衰弱与生活行为因素的关联研究[J].预防医学,2022,34(3):263-267. |
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