Cognitive screening among older adults with diabetes across diverse clinic settings

Abstract

Aims: Diabetes increases risk of cognitive dysfunction and dementia, which can make it harder to manage diabetes. We aimed to examine cognitive screening for older adults with diabetes in 1) endocrine (Endo), 2) geriatric (Geri) and 3) multidisciplinary endocrine-geriatric (Geri-Endo), to study differences between these settings and to elucidate risk factors of cognitive dysfunction.

Methods: We performed cognitive screening for subsets of patients ≥ age 65 with diabetes in one large healthcare system. We compared results and differences from the three clinic types and used adjusted multivariate logistic regression models to predict risk of cognitive dysfunction.

Results: Among 198 patients screened, those in Geri-Endo (N = 86) and Geri (N = 32) were more likely to have lower Mini-Cog scores, higher prevalence of hypertension and cardiovascular (CV) events. Endo and Geri-Endo patients had longer durations of diabetes, higher incidence of hypoglycemia, and were more likely to use insulin. Age > 75 years (p = 0.0105), previous CV events (p = 0.0006) and body mass index < 30 (p = 0.0115) were significantly associated with lower Mini-Cog scores.

Conclusions: Our study shows that cognitive screening can help identify at risk older adults with diabetes. Thus, yearly screening should be part of routine diabetes care.

Keywords: Cognitive dysfunction; Dementia; Diabetes; Older adults.