Prevalence of cognitive impairment in ambulatory patients with type 2 diabetes attending diabetic clinic at Kenyatta national hospital.
Abstract
Background: Type 2 diabetes (T2D) cases have increased significantly in the recent past with
more than 422 million diagnoses in 2016. With rise in the number of cases, there is expected
increase in diabetic complications. Researchers have provided a greater emphasis on the
existing relationship between T2D and cognitive impairment globally. However, there is no
information on the prevalence of cognitive impairment among T2D patients in Kenya.
Objective: To determine the prevalence of Cognitive impairment in ambulatory patients with
T2D attending the diabetic clinic at Kenyatta national hospital (KNH).
Methods: The study used a cross-sectional research design. Consecutive sampling technique
was used to select participants based on the outlined inclusion criteria. Data collection was
done using a survey questionnaire which included study proforma and Mini-Mental State
Examination (MMSE). A Sample of 369 participants attending the diabetic clinic at Kenyatta
National Hospital were recruited at a 5% margin of error of which 367 successfully filled in
the study proforma showing a 99.5% response rate. MMSE was done to determine cognitive
dysfunction among T2D. Chi-square test for association and multiple regression analyses were
conducted at 0.05 level of significance.
Results: A total of 367 respondents were analyzed. Majority of the respondents, 60.8% were
female, 48.2% had secondary school education, 75.7% were married and the mean age was
57.7 (SD=11.3) years. The mean duration since diagnosis of T2D was 10.8 (SD = 8.4) years.
Results also showed that 70% of the respondents had hypertension. The mean HBA1c was 8.45
(SD = 2.6) %. The prevalence of cognitive impairment was 32%: mild cognitive impairment
in 27% and 5% had moderate cognitive impairment. The results showed that age, (p < 0.001),
level of education (p < 0.001) and duration of diabetes (p = 0.034) were significantly associated
with cognitive dysfunction. Age (p<0.001), level of education (P<0.001) and HBA1c (p=0.025)
were statistically significant predictors of cognitive impairment in T2D patients.
Conclusion: The prevalence of cognitive impairment among T2D patients is increasing with
age and off target HBA1c levels (poor glycemic control). There is an inverse relationship
between low formal educational level and cognitive impairment among T2D patients.
Optimizing adequate glycemic control and improving formal education up to tertiary level are
essential in limiting cognitive dysfunction among T2D patients. Older adults are at increased
risk hence should be prioritized in screening of cognitive dysfunction.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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