Introduction: Diabetes mellitus is a frequent and systemic illness. Deleterious effects on cognition are one of its lesser known consequences. Diabetic individuals are at an increased risk for development of dementia in the future. Objective: To compare cognitive function in middle aged diabetic population with non-diabetic control group, in order to determine high risk population for developing cognitive decline or dementia in the future. Methodology: This is a cross-sectional, observational study conducted in Guayaquil. We studied 309 individuals between the ages of 55 and 65 years, of which 142 were diabetics and 167 were non-diabetic controls. A neuropsychological evaluation was performed to assess memory, attention, executive functioning and processing speed. Results: Group comparisons revealed significant differences between diabetics and non-diabetics in systolic blood pressure (p<.001), hyperlipidemia (p<.001) and cardiovascular risk (p < .001). Cognitive performance, after considering differences in scholarship, was lower in diabetic people (memory p values between .000 and .002; attention p values between .000 and .019; executive function p values between .000 and .001). Correlation between years of disease and cognitive decline was not significant (memory -.055; attention -.040; executive function .0169). Correlation between glycated hemoglobin and cognitive performance was significant for all evaluated functions (memory -.219; attention -.186; executive function -.269). Conclusion: Middle aged diabetic population has lower cognitive performance compared with non diabetics. The identification of individuals at risk for cognitive decline will contribute to the development and implementation of intervention strategies that will allow the slowing of cognitive decline in vulnerable individuals.
Diabetes mellitus
Deterioro Cognitivo en Pacientes Diabéticos De 55 a 65 Años de Edad. Reporte Final de Estudio Observacional, Transversal en la Ciudad de Guayaquil. Cognitive Impairment In Diabetic Patients Between 55 And 65 Years Old. Final Report Of A Cross-Sectional, Observational Study In Guayaquil City.
Razonamiento Clínico: Hombre de 57 Años de Edad con Dolor y Debilidad Muscular Proximal
We present a case of a 57-year-old man with a two-month history of shoulder pain and proximal weakness. The history and physical examination are reviewed and a stepwise approach to the differential diagnosis is made to reach the final diagnosis.
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Diabetes Mellitus y Cognición. Estudio Transversal.
Diabetes Mellitus Type 2 is associated with greater impairment of cognitive ability, and abnormalities in brain imaging studies compared with people without diabetes.
Objective: To determine if there is a difference in the score of cognitive function tests Addenbrooke (ACE) and Cognitive Ability Screening Instrument (CASI) among patients with type 2 diabetes and non-diabetics.
Methods: Cross sectional study of patients with a history of more than 5 years of diabetes mellitus type 2, between 45 and 64 years of Outpatient of Endocrinology Department, Hospital Teodoro Maldonado Carbo Guayaquil between September 1 and December 31, 2008, who had the cognitive assessment test: ACE and CASI.
Results: There were a total of 68 patients, of which 60.3% had diabetes mellitus, with an average age of 60 years, of this group: 53.6% were men and 46.3% were women. Hypertension was present in 39%. 14.6% were treated with oral antidiabetic agents and 73.2% with insulin. Glycated haemoglobin (Hb1Ac) was abnormal in 33.8%. With regard to the tests of cognitive assessment: the average score of ACE in diabetic patients was 88. 8 and in non-diabetic patients 90.1 and in the CASI the average was 91.5 in diabetics and 92.5 in non-diabetics.
Conclusions: The score of cognitive function tests Addenbrooke and CASI was lower in diabetics compared to non-diabetics, although there was no significant difference.
