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.