nach oben

International Journal of Diabetes in Developing Countries

Erschienen in:

28.12.2017 | Original Article

Depression and mild cognitive impairment (MCI) among elderly patients with type 2 diabetes mellitus in Pakistan: possible determinants

verfasst von: Muhammad Atif, Quratulain Saleem, Shane Scahill

Erschienen in: International Journal of Diabetes in Developing Countries | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

Abstract

This descriptive, cross-sectional, questionnaire-based study was designed to assess the extent of depression and mild cognitive impairment (MCI) and their possible determinants among the elderly with type 2 diabetes mellitus in Pakistan. The study was carried out at the diabetes outpatient clinics of two tertiary care hospitals in Lahore, district of Punjab in Pakistan using convenience sampling techniques between December 1, 2015 and February 28, 2016. All consenting patients were interviewed to complete the Geriatric Depression Scale (GDS-15) and the Montreal Cognitive Assessment (MoCA). Standard scoring schemes were used for these scales. Multiple logistic regression analysis was carried out to identify any statistically significant variables from the univariate analysis, to segregate independent factors. A p value < .05 was taken as the mark of statistical significance for tests. A total of 490 elderly patients with type 2 diabetes mellitus were approached. Of those, 400 patients agreed to participate, resulting in a response rate of 81.6%. GDS-15 scores suggest that only 130 (32.5%) patients were not depressed to some degree. High HbA₁C and MCI were significant predictors of depression. MoCA scores indicated that 269 (67.3%) patients had MCI, and depression was the only predictor of MCI among the study patients. The implications of the findings include the need by healthcare providers to consider the assessment and management of depression and MCI as part of diabetes treatment protocols so that elderly patients can achieve positive diabetes outcomes and have improved health-related quality of life.

Unwin N, Gan D, Whiting D. The IDF diabetes atlas: providing evidence, raising awareness and promoting action. Diabetes Res Clin Pract. 2010;87(1):2–3. https://doi.org/10.1016/j.diabres.2009.11.006.CrossRefPubMed

World Health Organization. Global report on Diabetes 2016. http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf?ua=1. Accessed 24 Octr 2017.

Kirkman MS, Briscoe VJ, Clark N, Florez H, Haas LB, Halter JB, et al. Diabetes in older adults. Diabetes Care. 2012;35(12):2650–64. https://doi.org/10.2337/dc12-1801.CrossRefPubMedPubMedCentral

International Diabetes Federation. Diabetes in Pakistan-2015. 2015. http://www.idf.org/membership/mena/pakistan. Accessed 27 May 2016.

Araki A, Ito H. Diabetes mellitus and geriatric syndromes. Geriatr Gerontol Int. 2009;9(2):105–14. https://doi.org/10.1111/j.1447-0594.2008.00495.x.CrossRefPubMed

World Health Organization. Depression 2016. http://www.who.int/topics/depression/en/. Accessed 12 June 2016.

Maraldi C, Volpato S, Penninx BW, Yaffe K, Simonsick EM, Strotmeyer ES, et al. Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: the health, aging, and body composition study. Arch Intern Med. 2007;167(11):1137–44. https://doi.org/10.1001/archinte.167.11.1137.CrossRefPubMed

Zuberi SI, Syed EU, Bhatti JA. Association of depression with treatment outcomes in type 2 diabetes mellitus: a cross-sectional study from Karachi, Pakistan. BMC Psychiatry. 2011;11(1):27. https://doi.org/10.1186/1471-244X-11-27.CrossRefPubMedPubMedCentral

Egede LE, Osborn CY. Role of motivation in the relationship between depression, self-care, and glycemic control in adults with type 2 diabetes. Diabetes Educ. 2010;36(2):276–83. https://doi.org/10.1177/0145721710361389.CrossRefPubMedPubMedCentral

10.

Brandimonte MA, Bruno N, Collina S: Psychological concepts: an international historical perspective: psychology press; 1 edition (July 25, 2006); 2006.

11.

de Mendonca A, Ribeiro F, Guerreiro M, Garcia C. Frontotemporal mild cognitive impairment. J Alzheimers Dis. 2004;6(1):1–9. https://doi.org/10.3233/JAD-2004-6101.CrossRefPubMed

12.

Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, et al. Current concepts in mild cognitive impairment. Arch Neurol. 2001;58(12):1985–92. https://doi.org/10.1001/archneur.58.12.1985.CrossRefPubMed

13.

Yaffe K, Falvey C, Hamilton N, Schwartz AV, Simonsick EM, Satterfield S, et al. Diabetes, glucose control, and 9-year cognitive decline among older adults without dementia. Arch Neurol. 2012;69(9):1170–5. https://doi.org/10.1001/archneurol.2012.1117.CrossRefPubMedPubMedCentral

14.

Cukierman T, Gerstein H, Williamson J. Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies. Diabetologia. 2005;48(12):2460–9. https://doi.org/10.1007/s00125-005-0023-4.CrossRefPubMed

15.

Gao Y, Xiao Y, Miao R, Zhao J, Cui M, Huang G, et al. The prevalence of mild cognitive impairment with type 2 diabetes mellitus among elderly people in China: a cross-sectional study. Arch Gerontol Geriatr. 2016;62:138–42. https://doi.org/10.1016/j.archger.2015.09.003.CrossRefPubMed

16.

Sacuiu S, Insel PS, Mueller S, Tosun D, Mattsson N, Jack CR Jr, et al. Alzheimer's disease neuroimaging I. Chronic depressive symptomatology in mild cognitive impairment is associated with frontal atrophy rate which hastens conversion to Alzheimer dementia. Am J Geriatr Psychiatry. 2016;24(2):126–35. https://doi.org/10.1016/j.jagp.2015.03.006.CrossRefPubMed

17.

Munshi M, Grande L, Hayes M, Ayres D, Suhl E, Capelson R, et al. Cognitive dysfunction is associated with poor diabetes control in older adults. Diabetes Care. 2006;29(8):1794–9. https://doi.org/10.2337/dc06-0506.CrossRefPubMedPubMedCentral

18.

Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. Lancet. 2007;370(9590):859–77. https://doi.org/10.1016/S0140-6736(07)61238-0.CrossRefPubMed

19.

Zakar R, Zakar MZ, Mikolajczyk R, Kraemer A. Spousal violence against women and its association with women's mental health in Pakistan. Health Care Women Int. 2013;34(9):795–813. https://doi.org/10.1080/07399332.2013.794462.CrossRefPubMed

20.

Raosoft. Sample size calculator 2004. http://www.raosoft.com/samplesize.html. Accessed 7 July 2016.

21.

Nasreddine Z. The montral cognitive assessment MoCA is a brief cognitive assessment tool for mild cognitive assessment tool. 2016. http://www.mocatest.org/. Accessed 13 July 2016.

22.

Nyunt MS, Fones C, Niti M, Ng TP. Criterion-based validity and reliability of the geriatric depression screening scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging Ment Health. 2009;13(3):376–82. https://doi.org/10.1080/13607860902861027.CrossRefPubMed

23.

Yesavage J. A, sheikh, Javaid I. Geriatric depression scale (GDS) recent evidence and development of a shorter violence. Clin Gerontol. 1986;5(1–2):165–73. https://doi.org/10.1300/J018v05n01_09.CrossRef

24.

Greenberg SA. The geriatric depression scale (GDS). 2012. http://nursing-mfp.webhost.uic.edu/education/neglect/GDS.pdf. Accessed 4 September 2017.

25.

World Health Organization. Management of substance abuse , process of translation and adaptation of instruments. 2016. http://www.who.int/substance_abuse/research_tools/translation/en/. Accessed 13 July 2016.

26.

Rahman TTA. Gaafary el, Mohamed M. Montreal cognitive assessment arabic version: reliability and validity prevalence of mild cognitive impairment among elderly attending geriatric clubs in Cairo. Geriatr Gerontol Int. 2009;9(1):54–61. https://doi.org/10.1111/j.1447-0594.2008.00509.x.CrossRefPubMed

27.

Nasreddine Z. Montreal cognitive assessment (MoCA) administration and scoring instructions 2004. http://www.mocatest.org/pdf_files/instructions/MoCA-Instructions-English_2010.pdf. Accessed 10 September 2017.

28.

Ryan KA, Weldon A, Huby NM, Persad C, Bhaumik AK, Heidebrink JL, et al. Caregiver support service needs for patients with mild cognitive impairment and Alzheimer disease. Alzheimer Dis Assoc Disord. 2010;24(2):171–6. https://doi.org/10.1097/WAD.0b013e3181aba90d.CrossRefPubMedPubMedCentral

29.

Finkelstein EA, Bray JW, Chen H, Larson MJ, Miller K, Tompkins C, et al. Prevalence and costs of major depression among elderly claimants with diabetes. Diabetes Care. 2003;26(2):415–20. https://doi.org/10.2337/diacare.26.2.415.CrossRefPubMed

30.

Trief PM. Depression in elderly diabetes patients. Diabetes. Spectrum. 2007;20(2):71–5.

31.

Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2006;23(11):1165–73. https://doi.org/10.1111/j.1464-5491.2006.01943.x.CrossRefPubMed

32.

Ceriello A. Postprandial hyperglycemia and diabetes complications is it time to treat? Diabetes. 2005;54(1):1–7. https://doi.org/10.2337/diabetes.54.1.1.CrossRefPubMed

33.

de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001;63(4):619–30. https://doi.org/10.1097/00006842-200107000-00015.CrossRefPubMed

34.

Palinkas LA, Barrett-Connor E, Wingard DL. Type 2 diabetes and depressive symptoms in older adults: a population-based study. Diabet Med. 1991;8(6):532–9. https://doi.org/10.1111/j.1464-5491.1991.tb01646.x.CrossRefPubMed

35.

Lustman PJ, Clouse RE. Depression in diabetic patients: the relationship between mood and glycemic control. J Diabetes Complicat. 2005;19(2):113–22. https://doi.org/10.1016/j.jdiacomp.2004.01.002.PubMedCrossRef

36.

Adisa R, Alutundu MB, Fakeye TO. Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in southwestern Nigeria. Phar pract. 2009;7(3):163–9.

37.

DeCoster VA. Challenges of type 2 diabetes and role of health care social work: a neglected area of practice. Health Soc Work. 2001;26(1):26–37. https://doi.org/10.1093/hsw/26.1.26.CrossRefPubMed

38.

Cukierman-Yaffe T, Gerstein HC, Williamson JD, Lazar RM, Lovato L, Miller ME, et al. Relationship between baseline glycemic control and cognitive function in individuals with type 2 diabetes and other cardiovascular rIsk factors the action to control cardiovascular risk in diabetes-memory in diabetes (ACCORD-MIND) trial. Diabetes Care. 2009;32(2):221–6. https://doi.org/10.2337/dc08-1153.CrossRefPubMedPubMedCentral

39.

Rosenberg PB, Mielke MM, Xue QL, Carlson MC. Depressive symptoms predict incident cognitive impairment in cognitive healthy older women. Am J Geriatr Psychiatry. 2010;18(3):204–11. https://doi.org/10.1097/JGP.0b013e3181c53487.CrossRefPubMedPubMedCentral

40.

Nys GM, van Zandvoort MJ, van der Worp HB, de Haan EH, de Kort PL, Jansen BP, et al. Early cognitive impairment predicts long-term depressive symptoms and quality of life after stroke. J Neurol Sci. 2006;247(2):149–56. https://doi.org/10.1016/j.jns.2006.04.005.CrossRefPubMed

41.

Ganguli M. Depression, cognitive impairment and dementia: why should clinicians care about the web of causation? Ind J Psychiatr. 2009;51(5):29.

42.

Gorska-Ciebiada M, Saryusz-Wolska M, Borkowska A, Ciebiada M, Loba J. Adiponectin, leptin and IL-1 beta in elderly diabetic patients with mild cognitive impairment. Metab Brain Dis. 2016;31(2):257–66. https://doi.org/10.1007/s11011-015-9739-0.CrossRefPubMed

43.

Xu W, Caracciolo B, Wang HX, Winblad B, Backman L, Qiu C, et al. Accelerated progression from mild cognitive impairment to dementia in people with diabetes. Diabetes. 2010;59(11):2928–35. https://doi.org/10.2337/db10-0539.CrossRefPubMedPubMedCentral

44.

Butters MA, Young JB, Lopez O, Aizenstein HJ, Mulsant BH, Reynolds CF 3rd, et al. Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues Clin Neurosci. 2008;10(3):345–57.PubMedPubMedCentral

45.

Reischies FM, Neu P. Comorbidity of mild cognitive disorder and depression--a neuropsychological analysis. Eur Arch Psychiatry Clin Neurosci. 2000;250(4):186–93. https://doi.org/10.1007/s004060070023.CrossRefPubMed

46.

Chodosh J, Kado DM, Seeman TE, Karlamangla AS. Depressive symptoms as a predictor of cognitive decline: MacArthur studies of successful aging. Am J Geriatr Psychiatry. 2007;15(5):406–15. https://doi.org/10.1097/01.JGP.0b013e31802c0c63.CrossRefPubMed

47.

Auning E, Selnes P, Grambaite R, Saltyte Benth J, Haram A, Lovli Stav A, et al. Muftuler londalen a, Fladby T, Aarsland D. Neurobiological correlates of depressive symptoms in people with subjective and mild cognitive impairment. Acta Psychiatr Scand. 2015;131(2):139–47. https://doi.org/10.1111/acps.12352.CrossRefPubMed

48.

Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurol. 2011;10(9):819–28. https://doi.org/10.1016/S1474-4422(11)70072-2.CrossRefPubMedPubMedCentral

49.

Jayaweera HK, Hickie IB, Duffy SL, Hermens DF, Mowszowski L, Diamond K, et al. Mild cognitive impairment subtypes in older people with depressive symptoms: relationship with clinical variables and hippocampal change. J Geriatr Psychiatry Neurol. 2015;28(3):174–83. https://doi.org/10.1177/0891988715573535.CrossRefPubMed

Titel: Depression and mild cognitive impairment (MCI) among elderly patients with type 2 diabetes mellitus in Pakistan: possible determinants
verfasst von: Muhammad Atif
Quratulain Saleem
Shane Scahill
Publikationsdatum: 28.12.2017
Verlag: Springer India
Erschienen in: International Journal of Diabetes in Developing Countries / Ausgabe 3/2018
Print ISSN: 0973-3930
Elektronische ISSN: 1998-3832
DOI: https://doi.org/10.1007/s13410-017-0600-3

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2018

A standardized approach based on dietary and multiple daily insulin injections for the management of diabetes in infants

Association of vitamin D deficiency and type 1 diabetes mellitus: a systematic review and meta-analysis

Factors associated with anxiety in type 2 diabetes mellitus patients in Pakistan

Factors affecting risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers

Psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes: a path analysis model

RSSDI consensus on self-monitoring of blood glucose in types 1 and 2 diabetes mellitus in India