title: Impact of diabetes on cognitive impairment and disability in elderly hospitalized patients with heart failure.
abstract: OBJECTIVE
  Heart failure (HF) and diabetes mellitus (DM) are each associated with cognitive impairment and disability. The aim of the present study was to evaluate the impact of DM on cognitive impairment and functional status in elderly hospitalized patients affected by HF.
  
  
  METHODS
  A total of 79 elderly hospitalized patients with HF were enrolled in the present study. They underwent physical and instrumental examination, and geriatric multidimensional assessment including Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), activities of daily living (ADL) and instrumental activities of daily living (IADL). Differences between groups were established by t-test, Spearman's correlation coefficient was searched to examine the relation between variables. All results were considered significant if P was <0.05.
  
  
  RESULTS
  HF and DM coexisted in 43 patients (54.4% of cases); when they occurred together patients showed, compared with non diabetic patients, a greater clinical severity of HF (44.2% were in New York Heart Association class IV vs 16.7%, P = 0.017), a lower MMSE score (20.4 ± 3.6 vs 23 ± 3.8, P = 0.004), and a lower number of preserved functions in ADL (3 ± 1.6 vs 4 ± 1.8, P = 0.008) and in IADL (3.2 ± 1.7 vs 4.6 ± 2.3, P = 0.003). The correlation between DM and cognitive impairment, and disability was confirmed by multivariate and univariate analysis.
  
  
  CONCLUSIONS
  We confirm that DM is frequent in elderly hospitalized patients with HF, and we report that it has a negative impact on cognitive functions and functional status, worsening cognitive impairment, and disability observed in these patients. Comprehensive geriatric assessment is necessary for older adults with HF, especially when DM coexists.
authors.affiliation: Unit and School of Geriatrics, Department of Internal Medicine, University of Messina, Messina, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Basile
authors.forename: Andrea
authors.initials: A
authors.lastname: Crucitti
authors.forename: Maria D
authors.initials: MD
authors.lastname: Cucinotta
authors.forename: Paolo
authors.initials: P
authors.lastname: Figliomeni
authors.forename: Antonio
authors.initials: A
authors.lastname: Lacquaniti
authors.forename: Antonino
authors.initials: A
authors.lastname: Catalano
authors.forename: Nancy
authors.initials: N
authors.lastname: Morabito
authors.forename: Michele
authors.initials: M
authors.lastname: Buemi
authors.forename: Antonino
authors.initials: A
authors.lastname: Lasco
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology*; D048909:Diabetes Complications / Q000150:complications*; D006233:Persons with Disabilities; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D008297:Male
keywords: cognitive impairment; diabetes; disability; elderly; heart failure