Diabetes, Metabolic Syndrome and Obesity (Jul 2024)
Assessment of Cognitive Flexibility in Jordanian Diabetic Patients by Wisconsin Card Sorting and Trail Making Tests: Implications with Demographic, Anthropometric and Therapeutic Variables
Abstract
Shaimaa Nasr Amin,1,2 Gehan El-Akabawy,3– 5 Mohammad Adel Abuqasem,6 Asem Abdullah AL-Rawashdeh,6 Maram Mohamed Ayyad,6 Ahmad Khalid Ibrahim,6 Ali Mohammad AlShawagfeih,6 Sara Khaled Ebdah,6 Rana Jassem AlHajri,6 Ahmed A Ismail7,8 1Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, Zarqa, Jordan; 2Department of Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt; 3Department of Basic Medical Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates; 4Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates; 5Department of Anatomy and Embryology, Faculty of Medicine, Menoufia University, Menoufia, Egypt; 6House Officer, Medical Graduates Training Program, Jordan Medical Council, Amman, Jordan; 7Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt; 8Department of Health and Environment, College of Public Health, University of Iowa, Iowa, KS, USACorrespondence: Shaimaa Nasr Amin, Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan, Tel +962770507906, Email [email protected]: Cognitive flexibility is a mental ability that aids in smoothly alternating between them tasks in the brain. Diabetes Mellitus (DM) is a, common disorder that has been associated with impairments in cognitive functions. This research is a retrospective case-control study aimed at establishing a clear relationship between cognitive flexibility and diabetes among Jordanians, considering demographic, anthropometric, and therapeutic variables.Patients and Methods: The Wisconsin Card Sorting Test (WCST)-64 item and the Trail Making Test (TMT) assessed cognitive flexibility in 268 people with diabetes and healthy control. Demographic, therapeutic data were collected. We also measured waist-to-hip ratio (WHR) and body mass index (BMI). As the variables were non-normally distributed, non-parametric statistical tests were used to examine differences (Kruskal–Wallis) and correlation (Spearman) between variables.Results: The patient group did worse on the WCST In contrast to the control group, patients exhibited more significant delays for both Part A and Part B of the TMT (p< 0.05). Males had higher WCST conceptual level responses than females. In addition, participants with professional jobs showed less delay in TMT Part A (p< 0.05). Age was positively correlated with WCST’s total errors and TMT’s Parts A and B (p< 0.05). BMI was negatively correlated with the WCST’s conceptual level of responses and positively correlated with TMT’s Part B (p< 0.05). In addition, urea and albumin levels were positively correlated with TMT’s Part A (p< 0.05). Furthermore, creatinine was positively correlated with WCST’s total errors and TMT’s Part A (p< 0.05).Conclusion: Some measures of cognitive flexibility are associated with DM status in the studied sample of Jordanians and other variables (educational levels, occupation, lifestyle, average duration of illness, and age).Keywords: cognitive flexibility, diabetes mellitus, Jordan, Wisconsin card sorting test, trail making test
