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Introduction: The aim of this study is to determine prevalence and risk factors of Cognitive Impairment (CI) and its association with Type 2 Diabetes Mellitus (T2DM) in subjects aged 65 years and above. Additionally, we attempt to provide a cognitive profile for T2DM group. Methodology: A cross-sectional analytical study to assess CI was carried out. We evaluated a sample of community-dwelling residents from Chile. All participants underwent a general interview, lifestyle questionnaires and a comprehensive neuropsychological battery. Regression analyses were performed to evaluate risk of CI with T2DM and influencing factors. Results between groups in the different domains of the neuropsychological assessment were compared by Student's t-tests and MANOVA. Results: Among all 358 subjects, overall T2DM prevalence were 17.3%. The prevalence of CI was higher in T2DM group compared to the healthy participants (30.7%, p < 0.001). The risk of CI was 2.8 times higher in older people with T2DM compared to older people without the diagnosis. Multiple regression analysis, adjusted for age and gender, demonstrated that age, education, presence of dyslipidemia, and T2DM duration were the predictor variables significantly associated with CI. T2DM group performed worse on global cognitive performance, attention, language, verbal memory, visual memory, visual constructional ability, and executive function. After adjusting for significant covariates from multiple regression analysis, a relationship between "cognition" and T2DM is still observed. Amnesic multi-domain impairment was the specific cognitive identified pattern for T2DM group. Conclusion: The present study confirms the high prevalence of CI with T2DM among Chilean older adults in a community-based population. T2DM is significantly associated with a higher risk of CI, and age, education, presence of dyslipidemia, and duration of T2DM are risk factors. T2DM patients with CI are impaired in multiple cognitive domains, even after adjusting covariables, resulting in an amnesic multi-domain cognitive profile.
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OBJECTIVES: Although some results are conflicting, numerous investigations have demonstrated that the Mediterranean Diet (MedDiet) has positive effects on brain health. This review intends to provide an update on the scientific evidence regarding the effects of adherence to the MedDiet on late-life cognitive disorders. DESIGN: A systematic review was performed. The PubMed and Scopus databases were searched for longitudinal studies and randomized controlled trials (RCTs) published between the databases' inceptions and May 4, 2020. PRISMA guidelines were followed; the quality of the studies was assessed using version 2 of the Cochrane risk-of-bias tool for the RCTs and the Newcastle-Ottawa Scale for the longitudinal studies. The results are reported descriptively. SETTINGS AND PARTICIPANTS: Middle-aged and older adults. MEASURES: The review's principal outcomes were cognitive decline, cognitive performance and function, Mild Cognitive Impairment (MCI), Alzheimer's disease (AD), and dementia. RESULTS: Forty-five of the 995 articles retrieved from the databases met our criteria. Seven were RCTs and 38 were longitudinal studies. Overall the studies showed that the MedDiet has some protective effects on cognitive decline. As far as cognition domains were concerned, the MedDiet was associated only with improved global cognition. The results were mixed for MCI and AD. There was no evidence that it has a beneficial effect on dementia. CONCLUSIONS AND IMPLICATIONS: The review's analysis confirmed that adherence to the MedDiet is associated with some improvement in cognitive health. The heterogeneity of the scoring systems assessing adherence to the MedDiet and of the modalities evaluating the cognitive outcomes has played no small role in the differences emerging in the results and has hindered efforts to interpret them. Although other interventional studies are warranted to confirm the efficacy of the MedDiet in preventing cognitive disorders, the results show that it can be considered part of a multifactorial approach to improve late-life cognitive function.
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Doença de Alzheimer , Transtornos Cognitivos , Disfunção Cognitiva , Dieta Mediterrânea , Idoso , Cognição , Disfunção Cognitiva/prevenção & controle , Humanos , Pessoa de Meia-IdadeRESUMO
Introducción: La prevalencia de enfermedades crónicas como la diabetes mellitus tipo 2 (DM2) y la demencia aumentan con el envejecimiento. En este contexto, se ha descrito una asociación entre DM2 y trastornos cognitivos. Sin embargo, existen escasos estudios en población hispana. Este trabajo presenta un estudio piloto que evaluará la factibilidad del proyecto DIABDEM el cual determinará la prevalencia de deterioro cognitivo y sus factores de riesgo en personas mayores con diagnóstico de DM2 en España y Chile. Materiales y métodos: Estudio piloto, observacional, no experimental, descriptivo-comparativo, transversal. La muestra se conformará por 72 participantes (39 españoles y 33 chilenos), hombres y mujeres, de 65 años o más, que viven en la comunidad, sin diagnóstico previo de demencia, con y sin diagnóstico de DM2. Los participantes completarán un protocolo de investigación exhaustivo que recogerá datos de variables neuropsicológicas, de estilo de vida, sociodemográficas y clínicas. Resultados esperados: Se espera evaluar la factibilidad del proyecto DIABDEM, lo cual permitirá determinar la prevalencia de deterioro cognitivo y sus factores de riesgo en personas mayores con DM2 posteriormente. Por un lado, se espera identificar factores de riesgo y protectores asociados potencialmente al desarrollo de deterioro cognitivo en DM2. Por otro, se pretende identificar una tendencia en el perfil neuropsicológico específico en personas mayores con DM2, proponiendo posteriormente una batería neuropsicológica corta y útil para discriminar de manera eficaz y precoz los trastornos cognitivos en personas con DM2. Conclusiones: Los hallazgos de este estudio piloto ayudarán a obtener mayor conocimiento acerca de la factibilidad del proyecto DIABDEM, el cual aportará evidencia acerca de las complicaciones cognitivas en las personas con DM2
Introduction: The prevalence of chronic noncommunicable diseases such as type 2 diabetes mellitus (T2DM) and dementia increase with ageing. In this context, an association between T2DM and cognitive impairment has been described in the literature. However, there are few studies in the Hispanic population. This research project presents a pilot study that will evaluate the feasibility of the DIABDEM project that will determine the prevalence of cognitive impairment in old people with diagnosis of T2DM in Spain and Chile. Materials and methods: It is a observation-based pilot study, non-experimental, descriptive-comparative and cross-sectional. The sample will involve 72 participants (39 Spaniards and 33 Chileans), 65 year-old or older, men and women, community dwelling, and who have not been previously diagnosed with dementia, with or without a T2DM diagnosis. Participants will fill in a research protocol form collecting socio-demographic and clinical data, lifestyle details, and neuropsychological variables. Expected results: This study will evaluate the feasibility of the DIABDEM project that will determine the prevalence rate of cognitive impairment in old people with T2DM. On one hand, the aim of this study will establish risk and protectors factors potentially associated with the development of cognitive impairment in T2DM. On the other hand, it is expected to identify a specific neuropsychological profile in people with T2DM, proposing later a brief and useful neuropsychological battery in order to discriminate early cognitive impairment in people with T2DM. Conclusion: Findings in this pilot study will obtain greater knowledge about the feasibility of the DIABDEM project, which will provide evidence about cognitive complications in T2DM
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Humanos , Masculino , Feminino , Idoso , Disfunção Cognitiva/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Chile/epidemiologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/psicologia , Estudos Transversais , Demência/epidemiologia , Demência/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/psicologia , Vida Independente , Estilo de Vida , Projetos Piloto , Prevalência , Fatores SocioeconômicosRESUMO
INTRODUCTION: The prevalence of chronic noncommunicable diseases such as type 2 diabetes mellitus (T2DM) and dementia increase with ageing. In this context, an association between T2DM and cognitive impairment has been described in the literature. However, there are few studies in the Hispanic population. This research project presents a pilot study that will evaluate the feasibility of the DIABDEM project that will determine the prevalence of cognitive impairment in old people with diagnosis of T2DM in Spain and Chile. MATERIALS AND METHODS: It is a observation-based pilot study, non-experimental, descriptive-comparative and cross-sectional. The sample will involve 72 participants (39 Spaniards and 33 Chileans), 65 year-old or older, men and women, community dwelling, and who have not been previously diagnosed with dementia, with or without a T2DM diagnosis. Participants will fill in a research protocol form collecting socio-demographic and clinical data, lifestyle details, and neuropsychological variables. EXPECTED RESULTS: This study will evaluate the feasibility of the DIABDEM project that will determine the prevalence rate of cognitive impairment in old people with T2DM. On one hand, the aim of this study will establish risk and protectors factors potentially associated with the development of cognitive impairment in T2DM. On the other hand, it is expected to identify a specific neuropsychological profile in people with T2DM, proposing later a brief and useful neuropsychological battery in order to discriminate early cognitive impairment in people with T2DM. CONCLUSION: Findings in this pilot study will obtain greater knowledge about the feasibility of the DIABDEM project, which will provide evidence about cognitive complications in T2DM.
