Undiagnosed cognitive impairment, health status and depressive symptoms in patients with type 2 diabetes.
OBJECTIVE
Type 2 diabetes (T2DM) is associated with cognitive impairment. We examined whether undiagnosed cognitive impairment in T2DM-patients is associated with a reduced health status and depressive symptoms.


METHODS
In an observational study, 225 T2DM-patients aged ≥70years were examined at their homes and (some of them) at a memory clinic for undiagnosed cognitive impairment (dementia or mild cognitive impairment [MCI], defined according to internationally accepted criteria). Questionnaires assessing health status (SF-36, EQ-5D, EQ-VAS) and depressive symptoms (CES-D) were filled out. Health status and depressive symptoms were compared between patients with and without cognitive impairment.


RESULTS
Patients with cognitive impairment (n=57) showed significantly lower scores on the physical and mental summary scores of the SF-36 than patients with normal cognition (difference: 3.5 (95%-CI 0.7-6.3, p=0.02, effect size 0.41) and 2.9 (95%-CI 0.3-5.6; p=0.03, effect size 0.37). EQ-5D index and EQ-VAS scores were significantly lower in patients with cognitive impairment. Depression (CES-D≥16) occurred almost twice as often in patients with cognitive impairment (RR 1.8; 95%-CI: 1.1-3.0).


CONCLUSIONS
Undiagnosed cognitive impairment in T2DM-patients is associated with a reduced health status and more depressive symptoms. Detection of cognitive impairment in T2DM-patients identifies a vulnerable patient group that could benefit from tailored treatment and care.
Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands. Electronic address: p.s.koekkoek-3@umcutrecht.nl.
Paula S
PS
Koekkoek
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
Geert Jan
GJ
Biessels
Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
Minke
M
Kooistra
Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
Jolien
J
Janssen
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
L Jaap
LJ
Kappelle
Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
Guy E H M
GE
Rutten
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D003704:Dementia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D035862:Vulnerable Populations
Cognitive impairment; Depressive symptoms; Elderly; Health status; Type 2 diabetes mellitus