Zhongguo quanke yixue (Jun 2024)
Community Management of Elderly Patients with Type 2 Diabetes Complicated with Mild Cognitive Impairment Related Factors
Abstract
Background Type 2 diabetes mellitus (T2DM) and mild cognitive impairment (MCI) are common health problems in the elderly in the community. Research on the status and influencing factors of MCI in the elderly with T2DM who participate in community management is needed. Objective To explore the cognitive characteristics and related factors of elderly patients with T2DM complicated with MCI under community management. Methods From July to October 2022, a total of 399 patients with type 2 diabetes over 60 years of age in a community health service center in Shanghai were selected by systematic sampling method. General demographic data and health problems, physical examination and laboratory test results, including fasting blood glucose (FBG), total triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1c) were collected. They were divided into MCI group (n=157) and non-MCI group (n=242) according to the presence or absence of MCI. Binary Logistic regression analysis was used to explore the influencing factors of MCI in elderly patients with type 2 diabetes under community management. Results The prevalence of MCI was 39.3% (157/399) in community-managed elderly patients with type 2 diabetes. The comparison of cognitive characteristics between MCI group and non-MCI group showed that the MCI group had higher abnormality rates in executive function, orientation, calculation, abstraction, delayed memory, visual perception, naming and attention than the non-MCI group, and the differences were statistically significant (P<0.05), and delayed memory impairment (92.4%) was the most common. There were significant differences in age, marriage, years of education, drinking, FBG, HbA1c, TC, LDL-C between the two groups (P<0.05) ; Binary Logistic regression analysis showed that age≥80 years old (OR=3.002, 95%CI=1.379-6.534), FBG≥7.0 mmol/L (OR=2.432, 95%CI=1.436-4.119), HbA1c 7%-9% (OR=2.349, 95%CI=1.380-3.997), HbA1c>9% (OR=5.106, 95%CI=2.150-12.130), LDL-C (OR=2.451, 95%CI=1.266-4.743), 7-12 years of education (OR=0.419, 95%CI=0.183-0.960) and >12 years (OR=0.243, 95%CI=0.086-0.692) was the influencing factor for MCI in elderly patients with type 2 diabetes (P<0.05) . Conclusion The prevalence of MCI in community-managed elderly patients with type 2 diabetes is high, and there are multiple cognitive impairment, age≥80 years old, FBG≥7.0 mmol/L, HbA1c 7%-9%, HbA1c>9% and high level of LDC. High level of education is a protective factor for MCI in community-managed elderly patients with type 2 diabetes. Early cognitive impairment screening, long-term blood glucose control, and lowering LDL-C levels are helpful to improve the cognitive function of community-managed elderly patients with type 2 diabetes.
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