Browse > Article
http://dx.doi.org/10.22722/KJPM.2018.26.1.59

Factors Influencing on the Cognitive Function in Type 2 Diabetics  

Goh, Dong Hwan (Department of Psychiatry, Kosin University College of Medicine)
Cheon, Jin Sook (Department of Psychiatry, Kosin University College of Medicine)
Choi, Young Sik (Department of Internal Medicine, Kosin University College of Medicine)
Kim, Ho Chan (Department of Psychiatry, Kosin University College of Medicine)
Oh, Byoung Hoon (Department of Psychiatry, Yonsei University College of Medicine)
Publication Information
Korean Journal of Psychosomatic Medicine / v.26, no.1, 2018 , pp. 59-67 More about this Journal
Abstract
Objectives : The aims of this study were to know the frequency and the nature of cognitive dysfunction in type 2 diabetics, and to reveal influencing variables on it. Methods : From eighty type 2 diabetics (42 males and 38 females), demographic and clinical data were obtained by structured interviews. Cognitive functions were measured using the MMSE-K (Korean Version of the Mini-Mental State Examination) and the Korean Version of the Montreal Cognitive Assessment (MoCA-K) tests. Severity of depression was evaluated by the Korean Version of the Hamilton Depression Rating Scale (K-HDRS). Results : 1) Among eighty type 2 diabetics, 13.75% were below 24 on the MMSE-K, while 38.8% were below 22 on the MoCA-K. 2) The total scores and subtest scores of the MoCA-K including visuospatial/ executive, attention, language, delayed recall and orientation were significantly lower in type 2 diabetics with cognitive dysfunction (N=31) than those without cognitive dysfunction (N=49) (p<0.001, respectively). 3) There were significant difference between type 2 diabetics with and those without cognitive dysfunction in age, education, economic status, body mass index, duration of diabetes, total scores of the K-HDRS, the MMSE-K and the MoCA-K (p<0.05, respectively). 4) The total scores of the MoCA-K had significant correlation with age, education, body mass index, family history of diabetes, duration of diabetes, total scores of the K-HDRS (p<0.05, respectively). 5) The risks of cognitive dysfunction in type 2 diabetics were significantly influenced by sex, education, fasting plasma glucose and depression. Conclusions : The cognitive dysfunction in type 2 diabetics seemed to be related to multiple factors. Therefore, more comprehensive biopsychosocial approaches needed for diagnosis and management of type 2 diabetes.
Keywords
Type 2 diabetes; Cognitive dysfunction; Sex; Education; Depression;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Cheke LG, Bonnici HM, Clayton NS, Simons JS. Obesity and insulin resistance are associated with reduced activity in core memory regions of the brain. Neuropsychologia 2017;96: 137-149.   DOI
2 Calvo-Ochoa E, Arias C. Cellular and metabolic alterations in the hippocampus caused by insulin signalling dysfunction and its association with cognitive impairment during aging and Alzheimer's disease: studies in animal models. Diabetes Metab Res Rev 2015;31:1-13.
3 Gonzalez-Reyes RE, Aliev G, Avila-Rodriques M, Barreto GE. Alterations in glucose metabolism on cognition: a possible link between diabetes and dementia. Curr Pharm Des 2016; 22:812-818.   DOI
4 Tomlin A, Sinclair A. The influence of cognition on self- management of type 2 diabetes in older people. Psychol Res Behav Manag 2016;9:7-20.
5 West RK, Ravona-Springer R, Heymann A, Schmeidler J, Leroith D, Koifman K, D'Arcy RCN, Song X, Guerrero-Berroa E, Preiss R, Hoffman H, Sano M, Silverman JM, Schnaider-Beeri M. Waist circumference is correlated with poorer cognition in elderly type 2 diabetes women. Alzheimer Dementia 2016;12:925-929.   DOI
6 Heni M, Kullmann S, Preissl H, Fritsche A, Haring H-U. Impaired insulin action in the human brain: causes and metabolic consequences. Nat Rev Endocrinol 2015;11:701-711.   DOI
7 Kleinridders A, Cai W, Cappellucci L, Ghazarian A, Collins WR, Vienberg SG, Pothos EN, Kahn CR. Insulin resistance in brain alters dopamine turnover and causes behavioral disorders. Proc Natl Acad Sci USA 2015;112:3463-3468.   DOI
8 Awad N, Gagnon M, Messier C. The Relationship between Impaired Glucose Tolerance, Type 2 Diabetes, and Cognitive Function. Journal of Clinical and Experimental Neuropsychology 2004;26:1044-1080   DOI
9 Dominguez RO, Pagano MA, Marschoff ER, Gonzalez SE, Repetto MG, Serra JA. Alzheimer disease and cognitive impairment associated with diabetes mellitus type 2: associations and a hypothesis. Neurologia 2014;29:567-572.   DOI
10 Wrighten SA, Piroli GG, Grillo CA, Reagan LP. A look inside the diabetic brain: Contributors to diabetes-induced brain aging. Biochim Biophys Acta 2009;1792:444-453.   DOI
11 Baglietto-Vargas D, Shi J, Yaeger DM, Ager R, LaFerla FM. Diabetes and Alzheimer's disease crosstalk. Neurosci Biobehav Rev 2016;64:272-287.   DOI
12 Pintana H, Apaijai N, Chattipakorn N, Chattipakorn SC. DPP-4 inhibitors improve cognition and brain mitochondrial function of insulin-resistant rats. J Endocrinol 2013;218:1-11.   DOI
13 Nelson PT, Smith CD, Abner EA, Schmitt FA, Scheff SW, Davis GJ, Keller JN, Jicha GA, Davis D, Wang-Xia W, Hartman A, Katz DG, Markesbery WR. Human cerebral neuropathology of Type 2 diabetes mellitus. Biochi Biophys Acta 2009;1792:454-469.   DOI
14 Biessels GJ, Kappelle LJ. Increased risk of Alzheimer's disease in Type II diabetes: insulin resistance of the brain or insulin-induced amyloid pathology? Biochem Soc Transact 2005; 33:1041-1044.
15 Kullmann S, Heni M, Hallschmid M, Fritsche A, Preissl H, Haring HU. Brian insulin resistance at the crossroads of metabolic and cognitive disorders in humans. Physiol Rev 2016; 96:1169-1209.   DOI
16 Zhao W-Q, Townsend M. Insulin resistance and amyloido- genesis as common molecular foundation for type 2 diabetes and Alzheimer's disease. Biochim Biophys Acta 2009;1792: 482-496.   DOI
17 Cholerton B, Baker LD, Craft S. Insulin resistance and pathological brain ageing. Diabet Med 2011;28:1463-1475.   DOI
18 Salkovic-Petrisic M, Tribl F, Schmidt M, Hoyer S, Riederer P. Alzheimer-like changes in protein kinase B and glycogen synthase kinase-3 in rat frontal cortex and hippocampus after damage to the insulin signalling pathway. J Neurochem 2006; 96:1005-1015.   DOI
19 Kullmann S, Heni M, Veit R, Scheffler K, Machann J, Haring H-U, Fritsche A, Preissl H. Selective insulin resistance in homeostatic and cognitive control brain areas in overweight and obese adults. Diabetes Care 2015;38:1044-1050.   DOI
20 Cetinkalp S, Simsir IY, Ertek S. Insulin resistance in brain and possible therapeutic approaches. Curr Vasc Pharmacol 2014;12:553-564.   DOI
21 De Felice FG, Lourenco MV, Ferreira ST. How does brain insulin resistance develop in Alzheimer's disease? Alzheimer Dementia 2014;10:S26-S32.   DOI
22 Ferreira ST, Clarke JR, Bomfm TR, De Felice FG. Infammation, defective insulin signaling, and neuronal dysfunction in Alzheimer's disease. Alzheimer Dementia 2014;10:S76-S83.   DOI
23 de la Monte SA, Wands JR. Review of insulin and insulinlike growth factor expression, signalling, and malfunction in the central nervous system: relevance to Alzheinmer's disease. J Alzheimer Dis 2005;7:45-61.   DOI
24 Diehl T, Mullins R, Kapogiannis D. Insulin resistance in Alzheimer's disease. Translational Res 2017;183:26-40.   DOI
25 Su F, Shu H, Ye Q, Wang Z, Xie C, Yuan B, Zhang Z, Bai F. Brain insulin resistance deteriorates cognition by altering the topological features of brain networks. Neuroimage Clin 2017;13:280-287.   DOI
26 Neumann KF, Rojo L, Navarrete LP, Farias G, Reyes P, Maccioni RB. Insulin resistance and Alzheimer's disease: Molecular links & clinical implications. Curr Alzheimer Res 2008;5:438-447.   DOI
27 Umegaki H. Insulin resistance in the brain: A new therapeutic target for Alzheimer's disease. J Diabet Invest 2013;4:150-151.   DOI
28 Holscher C, Li L. New roles for insulin-like hormones in neuronal signalling and protection: New hopes for novel treatment of Alzheimer's disease? Neurobiol Aging 2010;31:1495-1502.   DOI
29 Stranahan AM, Norman ED, Lee K, Cutler RG, Telljohann R, Egan JM, Mattson MP. Diet-induced insulin resistance impairs hippocampal synaptic plasticity and cognition in middle-aged rats. Hippocampus 2008b;18:1085-1088.   DOI
30 Stranahan AM, Arumugam TV, Cutler RG, Lee K, Egan JM, Mattson MP. Diabetes impairs hippocampal function through glucocorticoid-mediated effects on new and mature neurons. Nat Neurosci 2008a;11:309-317.   DOI
31 Datusalia AK, Sharma SS. Amelioration of diabetes-induced cognitive defcits by GSK-$3{\beta}$ inhibition is a attributed to modulation of neurotransmitters and neuroinflammation. Mol Neurobiol 2014;50:390-405.   DOI
32 Willette AA, Xu G, Johnson SC, Birdsill AC, Jonaitis EM, Sager MA, Hermann BP, Rue AL, Asthana S, Bendlin BB. Insulin resistance, brain atrophy, and cognitive performance in late middle-aged adults. Diabetes Care 2013;36:443-449.   DOI
33 Meneilly GS, Tessier DM. Diabetes, dementia and hypoglycemia. Can J Diabetes 2016;40:73-76.   DOI
34 Roriz-Filho JS, Sa-Roriz TM, Rosset I, Camozzato AL, Santos AC, Chaves MLF, Moriguti JC, Roriz-Cruz M. (Pre) diabetes, brain aging, and cognition. Biochim Biophys Acta 2009;1792:432-443.   DOI
35 Mwamburi M, Qiu WQ. Different associations of premorbid intelligence vs. current cognition with BMI, insulin and diabetes in the homebound elderly. Integr Mol Med 2016;3:547- 552.
36 Cole AR, Astell A, Green C, Sutherland C. Nolecular connexions between dementia and diabetes. Neurosci Biobehav Rev 2007;31:1046-1063.   DOI
37 Mittal K, Katare DP. Shared links between type 2 diabetes mellitus and Alzheimer's disease: A review. Diabet Metabol Synd Clin Res Rev 2016;10S:S144-S149.
38 Kwon YC, Park JH. Korean Version of Mini-Mental State Examination (MMSE-K) Part I: Development of the Test for the Elderly. J Korean Neuropsychiatr Assoc 1989;28:125-135.
39 Moran C, Phan TG, Chen J, Blizzard L, Beare R, Venn A, Munch G, Wood AG, Forbes J, Greenaway TM, Pearson S, Srikanth V. Brain atrophy in type 2 diabetes: Regional distribution and infuence on cognition. Diabetes Care 2013;36:4036- 4042.   DOI
40 Lee JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, Woo HW, Lee HS, Han SI, Kim YS. Validity and Reliability of the Korean Version of the Hamilton Depression Rating Scale. J Korean Neuropsychiatr Assoc 2005;44:456-465.
41 Park JH, Kwon YC. Standardization of Korean Version of Mini-Mental State Examination(MMSE-K) for Use in the Elderly. Part II: Diagnostic Validity. J Korean Neuropsychiatr Assoc 1989;28:508-513.
42 Nasreddine Z, Lee JY. Korean Version of the Montreal Cognitive Assessment. March 1, 2006. Available from: URL:http://www.mocatest.org.
43 Nazem S, Siderowf AD, Duda JE, Have TT, Colcher A, Horn SS. Montreal cognitive assessment performance in patients with Parkinson's examination score. J Am Geriatr Soc 2009;57:304-308.   DOI
44 Lee JY, Lee DW, Cho SJ, Na DL, Jeon HJ, Kim SK. Brief screening for mild cognitive impairment in elderly outpatient clinic: Validation of the Korean Version of the Montreal Cognitive Assessment. J Geriatr Psychiat Neurol 2008;21:104-110.   DOI
45 Bourdel-Marchasson I, Lapre E, Laksir H, Puget E. Insulin resistance, diabetes and cognitive function: consequences for preventive strategies. Diabetes Metab 2010;36:173-181.   DOI
46 Messier C. Impact of impaired glucose tolerance and type 2 diabetes on cognitive aging. Neurobiol Aging 2005;26S:S26-S30.