Cognitive capacity and functional development assessment in elderly people with Type 2 Diabetes Mellitus

Albernaz, Emanuelle de Oliveira; Dutra, Luz Marina Alfonso; Bastos, Cláudia Regina Biancato; Sete, Alexandra Rubim Camara; Carvalho, Rawany Teixeira; Melo, Manuela Costa

doi:10.1590/0034-7167-2019-0306

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (05) • 2021 • https://doi.org/10.1590/0034-7167-2019-0306 copy

Cognitive capacity and functional development assessment in elderly people with Type 2 Diabetes Mellitus

Avaliação da capacidade cognitiva e do desenvolvimento funcional em adultos idosos com diabetes mellitus tipo 2

Evaluación de la capacidad cognitiva y del desarrollo funcional en adultos mayores con diabetes mellitus tipo 2

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the cognitive capacity and functional development of the elderly with and without diabetes.

Methods:

case-control study, comparing elderly people with and without diabetes. 218 patients interviewed in outpatient clinics: geriatrics and endocrinology. Validated instruments were used for cognitive and functional assessment.

Results:

people with diabetes had low scores on cognitive tests. HbA1c and education were related to memory loss, compromising the basic and instrumental activities of daily life.

Conclusion:

this study evaluated that high glycemic values affect the autonomy of the elderly, compromising cognition and functional performance in activities of daily living.

Descriptors:
Health of the Elderly; Cognition; Self-Care; Diabetes Mellitus; Secondary Care

Variable	Elderly people with Diabetes				Elderly people without Diabetes
Variable	Minimum	Maximum	Mean	Standard deviation	Minimum	Maximum	Mean	Standard deviation
Age	60.0	91.0	68.3	6.6	60.0	95.0	69.0	7.1
HbA1C	5.1	11.3	7.2	1.4	-	-	-	-
Time diagnosis (years)	0.5	53.0	14.6	11.5	-	-	-	-
Mini-Mental	12.0	29.0	22.3	4.6	17.0	30.0	24.8	3.2
Verbal Fluency Animals	4.0	19.0	11.7	3.8	5.0	21.0	12.9	3.4
Verbal Fluency Fruits	3.0	18.0	10.3	3.2	5.0	18.0	11.0	3.0
Clock Test	1.0	9.0	3.9	2.7	1.0	10.0	5.8	2.7

Variable		Frequency (%)
Variable		Patients with Diabetes	Patients without Diabetes
Gender	Male	35 (32.1)	26 (23.9)
	Female	74 (67.9)	83 (76.1)
Schooling	None	16 (14.7)	17 (15.6)
	Some elementary school	41 (37.6)	31 (28.4)
	Elementary school	12 (11.0)	12 (11.0)
	Some high school	11 (10.1)	3 (2.8)
	High school	25 (22.0)	32 (29.4)
	Some Higher Education	0 (0.0)	1 (0.9)
	Complete Higher Education	4 (3.7)	12 (11.0)
	Graduate	0 (0.0)	1 (0.9)
Basic Activities of Daily Living - Katz Index	Independence	60 (55.0)	84 (77.1)
	Care	49 (45.0)	25 (22.9)
	Dependency	0 (0.0)	0 (0.0)
Instrumental Activities of Daily Living Lawton Index	Independence	48 (44.0)	74 (67.9)
	Care	53 (48.6)	33 (30.3)
	Dependency	8 (7.3)	2 (1.8)
Total		190 (100.0)	190 (100.0)

Response variable		Non-standard coefficients		Standard coefficients			95% CI for B
Response variable		B	Standard error	Beta	t	P	Inferior Limit	Superior Limit
Cognitive Assessment - MEEM	(Constant)	35.346	4.276		8.266	0.000	26.866	43.826
	Age	-0.215	0.055	-0.307	-3.914	0.000	-0.324	-0.106
	Gender	-0.877	0.725	-0.089	-1.211	0.229	-2.314	0.560
	Glycated Hemoglobin %	-0.144	0.247	-0.043	-0.585	0.560	-0.634	0.345
	Time since diagnosis	0.051	0.031	0.127	1.635	0.105	-0.011	0.112
	Schooling	1.675	0.210	0.584	7.968	0.000	1.258	2.092
Verbal Fluency Test - animals	(Constant)	22.336	4.323		5.167	0.000	13.762	30.910
	Age	-0.069	0.056	-0.121	-1.244	0.216	-0.179	0,041
	Gender	-1.791	0.733	-0.222	-2.445	0.016	-3.244	-0.338
	Glycated Hemoglobin %	-0.482	0.250	-0.174	-1.929	0.056	-0.977	0.013
	Time since diagnosis	-0.045	0.031	-0.138	-1.440	0.153	-0.107	0.017
	Schooling	0.587	0.213	0.250	2.764	0.007	0.166	1.009
Verbal Fluency est - Fruits	(Constant)	15.734	3.600		4.370	0.000	8.593	22.874
	Age	-0.074	0.046	-0.155	-1.611	0.110	-0.166	0.017
	Gender	0.065	0.610	0.010	0.106	0.915	-1.145	1.275
	Glycated Hemoglobin %	-0.218	0.208	-0.094	-1.046	0.298	-0.630	0.195
	Time since diagnosis	-0.025	0.026	-0.090	-0.950	0.344	-0.077	0.027
	Schooling	0.704	0.177	0.357	3.977	0.000	0.353	1.055
Clock Test	(Constant)	8.106	2.888		2.807	0.006	2.379	13.834
	Age	-0.058	0.037	-0.144	-1.559	0.122	-0.131	0.016
	Gender	0.703	0.489	0.124	1.437	0.154	-0.267	1.674
	Glycated Hemoglobin %	-0.405	0.167	-0.208	-2.430	0.017	-0.736	-0.074
	Time since diagnosis	0.011	0.021	0.047	0.518	0.605	-0.031	0.052
	Schooling	0.646	0.142	0.392	4.552	0.000	0.365	0.928

Response variable								95% CI for EXP(B)
Response variable		B	S.E.	Wald	df	P	Exp(B)	Inferior	Superior
Basic Activities of Daily Living (BADL)	Age	0.078	0.036	4.552	1	0.033	1.081	1.006	1.161
	Gender	-0.763	0.453	2.844	1	0.092	0.466	0.192	1.132
	Glycated Hemoglobin	0.117	0.154	0.577	1	0.448	1.124	0.831	1.520
	Time since diagnosis	0.009	0.020	0.189	1	0.664	1.009	0.970	1.049
	Schooling	-0.156	0.133	1.373	1	0.241	0.856	0.659	1.111
	Constant	-4.886	2.744	3.171	1	0.075	0.008
Instrumental Activities of Daily Living (IADL)	Age	0.049	0.036	1.851	1	0.174	1.051	0.978	1.128
	Gender	-0.500	0.463	1.164	1	0.281	0.607	0.245	1.504
	Glycated Hemoglobin	0.174	0.160	1.182	1	0.277	1.190	0.870	1.628
	Time since diagnosis	0.002	0.020	0.011	1	0.917	1.002	0.963	1.043
	Schooling	-0.326	0.134	5.936	1	0.015	0.722	0.555	0.938
	Constant	-2.873	2.763	1.081	1	0.298	0.057

		Glycated Hemoglobin		Total
		Compensated	Uncompensated	Total
Schooling	None	9	7	16
	Some elementary school	15	26	41
	Elementary school	7	5	12
	Some high school	6	5	11
	High school	20	5	25
	Higher Education	1	3	4
Total		58	51	109

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[1] Corresponding Author: Emanuelle de Oliveira Albernaz Email:emanuelle.albernaz@hotmail.com