Factors Related to Cognitive Impairment in Persons with Type 2 Diabetes
Keywords:
obesity, physical activity, trait anxiety, cognitive impairment, type 2 diabetesAbstract
Objective: To examine relationships between type 2 diabetes patients’ cognitive impairment and the factors of obesity, physical activity, and trait anxiety, with the confounding variables (i.e., personal factors and health/sickness factors) controlled
Design: Analytical research, case-control, outcome-to-cause study
Methodology: This study was conducted on a sample of 264 type 2 diabetes patients treated at the Diabetes Clinic and the General Internal Medicine Department of a tertiary hospital. Data were collected from August to December 2020. The informants were divided into case (88 patients with cognitive impairment) and control (176 patients with normal cognitive ability) groups, using the Montreal Cognitive Assessment (MoCA, Thai version, 2011). The data-collecting instruments consisted of: 1) the personal information interview form; 2) the Thai version of MoCA (2011); 3) the Global Physical Activity Questionnaire (GPAQ); and 4) the Trait Anxiety Inventory Form Y-2. The data were analysed using descriptive statistics and multivariate analysis with multiple logistic regression analysis.
Results: Overall, the majority of the informants were female averagely aged 55.32 years (SD = 4.04). Nearly half (44.30%) belonged to class 1 body mass index, 53.40% had insuffcient physical activity, and 65% displayed a low level of trait anxiety. The members of the control were averagely aged 52.02 years (SD = 6.25), of whom 33% belonged to class 1 body mass index, 72.20% performed suffcient physical activity, and 68.0% had a low level of trait anxiety, respectively. With the confounding variables (i.e., personal factors and health/sickness factors) controlled, the factors related to the informants’ cognitive impairment were the age of ≥ 50 years (OR = 6.73, 95% CI = 2.53-17.86, p < .01), unemployment (OR = 2.71, 95% CI = 1.24-5.95, p < .05), a body mass index of ≥ 25 25 kg/m2 (OR = 5.88, 95% CI = 2.81-12.28, p < .01), and insuffcient physical activity (OR = 2.24, 95% CI = 1.21-4.13, p < .05). However, trait anxiety was not found to be related to the informants cognitive impairment.
Recommendations: Obesity and insuffcient physical activity were identifed as contributing to cognitive impairment in type 2 diabetes patients. Nurses are, therefore, recommended to develop a care programme that promotes physical activity and weight control, in order to reduce the risk of cognitive impairment in this group of patients and prepare them for appropriate treatment and nursing care methods.
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