Assessment of the Cognitive Status in Diabetes Mellitus.

Assistant Professor, Department of Physiology, PSG IMS&R. .
Journal of clinical and diagnostic research : JCDR 12/2012; 6(10):1658-1662. DOI: 10.7860/JCDR/2012/4837.2649
Source: PubMed

ABSTRACT BACKGROUND AND OBJECTIVES: Diabetes is considered as an independent risk factor for cognitive impairment and dementia. In this study, we assessed the cognitive status of diabetics and non diabetics by the Mini Mental Status Examination (MMSE) and the Modified Mini Mental Status Examination (3MS) and also found a correlation of age, sex, the duration of diabetes and HbA1C with the cognitive status among the diabetics. MATERIALS AND METHODS: Thirty males and females above the age of 50 years, with and without diabetes, were included in the study. Both the groups underwent a cognition assessment by MMSE and 3MS and they scored 30 and 100 respectively. The correlation of age, sex, the duration of diabetes and HbA1C among the diabetics with 3MS was also done. STATISTICAL ANALYSIS: The analysis was done by using the SPSS software, version 13. The unpaired t test and one way ANOVA were used for various analyses. A p value of < 0.05 was considered to be statistically significant. RESULTS: The diabetics showed decreased MMSE and 3MS scores (p<0.001). 63.33% of the diabetics had a decreased cognition, based on the MMSE and 70% of the diabetics had a decreased cognition, based on the 3MS. The correlation of age, sex, the duration of diabetes and HbA1C among the diabetics with cognition status was not significant. CONCLUSION: Diabetes is associated with lower levels of the cognitive function. By the early implementation of MMSE, we can detect even a mild cognitive impairment, so that adequate treatment can be given, to prevent dementia.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The objectives of this study were to assess whether Teng's modification of the Mini-Mental State Examination (MMSE) improves its performance as a screening test for cognitive impairment and dementia, and to replicate this comparison in French and English language groups, and for differing assumptions concerning the relative importance of false negative and false positive errors. Screening interviews were conducted with representative samples of people aged 65 or over, set in 36 communities in 10 Canadian provinces. There were 8900 community participants in the Canadian Study of Health and Aging, of whom 1600 also underwent an extensive clinical and neuropsychological examination. Sensitivity, specificity and areas under the receiver operating characteristic (ROC) curve for the original MMSE and modified version (the 3MS) were the main outcome measures. Results are reported for French and English versions of the tests. The results indicate the alpha internal consistency for the 3MS was 0.87, compared to 0.78 for the MMSE. The area under the ROC curve in identifying dementia was 0.93 for the 3MS and 0.89 for the MMSE (p < 0.001). There was less difference between the two tests in identifying all levels of cognitive impairment (AUC 0.80 versus 0.77, p < 0.01). The superiority of the 3MS appears more due to its extended scoring system than to its additional questions. The validity of the MMSE was comparable in English and French samples; results for the 3MS were inconsistent between the two samples, suggesting possible translation problems. In conclusion, the 3MS was superior to the MMSE, justifying the slightly greater burden for its administration and scoring. Neither test worked well in identifying lower levels of cognitive impairment.
    Journal of Clinical Epidemiology 04/1997; 50(4):377-83. DOI:10.1016/S0895-4356(97)00060-7 · 5.48 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The relation between diabetes and major types of dementia is controversial. This systematic review examines the incidence of dementia in people with diabetes mellitus. We identified 14 eligible longitudinal population-based studies of variable methodological quality. The incidence of "any dementia" was higher in individuals with diabetes than in those without diabetes in seven of ten studies reporting this aggregate outcome. This high risk included both Alzheimer's disease and vascular dementia (eight of 13 studies and six of nine studies respectively). Detailed data on modulating and mediating effects of glycaemic control, microvascular complications, and comorbidity (eg, hypertension and stroke) were generally absent. The findings of mechanistic studies suggest that vascular disease and alterations in glucose, insulin, and amyloid metabolism underlie the pathophysiology, but which of these mechanisms are clinically relevant is unclear. Further high quality studies need to be initiated, with objective diabetes assessment, together with reliable methods to establish the contribution of vascular disease and other comorbidity to dementia.
    The Lancet Neurology 02/2006; 5(1):64-74. DOI:10.1016/S1474-4422(05)70284-2 · 21.82 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: 100 years after the first description, Alzheimer's disease is one of the most disabling and burdensome health conditions worldwide. We used the Delphi consensus method to determine dementia prevalence for each world region. 12 international experts were provided with a systematic review of published studies on dementia and were asked to provide prevalence estimates for every WHO world region, for men and women combined, in 5-year age bands from 60 to 84 years, and for those aged 85 years and older. UN population estimates and projections were used to estimate numbers of people with dementia in 2001, 2020, and 2040. We estimated incidence rates from prevalence, remission, and mortality. Evidence from well-planned, representative epidemiological surveys is scarce in many regions. We estimate that 24.3 million people have dementia today, with 4.6 million new cases of dementia every year (one new case every 7 seconds). The number of people affected will double every 20 years to 81.1 million by 2040. Most people with dementia live in developing countries (60% in 2001, rising to 71% by 2040). Rates of increase are not uniform; numbers in developed countries are forecast to increase by 100% between 2001 and 2040, but by more than 300% in India, China, and their south Asian and western Pacific neighbours. We believe that the detailed estimates in this paper constitute the best currently available basis for policymaking, planning, and allocation of health and welfare resources.
    The Lancet 01/2006; 366(9503):2112-7. DOI:10.1016/S0140-6736(05)67889-0 · 39.21 Impact Factor