Impact of treatment modality on cognition in older adults with type 2 diabetes mellitus.

Abstract

Cognitive impairment impacts functionality and health outcomes in older adults with diabetes mellitus. Crucially, managing diabetes involves many self-management activities that require adequate cognitive abilities. Pharmacological therapy for diabetes mellitus in older persons should address both cognitive functions and glycaemic control. To examine the relationship between the treatment modality of diabetes and cognitive functions in the elderly. A cross-sectional hospital-based study of older adults with type 2 diabetes mellitus over 1 year was conducted. Sociodemographic, relevant clinical details were obtained; Mini-Mental Status Examination (MMSE), Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), Trail-Making B test, F-A-S fluency, and categorical fluency test were assessed. Descriptive statistics, a generalized linear model, and a structural equation model with path analysis were performed to understand the relationship between treatment modality for diabetes and cognitive functions in the elderly. A total of 134 diabetic patients with a mean age of 68.06 + 6.29 years were assessed. The oral hypoglycaemic agent (OHA) treatment group has significantly better glycaemic control than the insulin group (<i>P</i> value < 0.001). The OHA treatment group performed significantly better in DSST, Trail-Making B test, F-A-S fluency, categorical fluency, and RAVLT (delayed recall, immediate memory). The OHA treatment group has a significant association with all cognitive test scores except DSST, RAVLT immediate memory, and learning which is further strengthened with SEM analysis. Compared to insulin, OHA has a beneficial effect on cognition in older adults with type 2 diabetes mellitus.