Cognitive impairment, physical disability and depressive symptoms in older diabetic patients: the Fremantle Cognition in Diabetes Study

Objective: To determine whether the prevalence of dementia, depression and/or disability in older diabetic subjects warrants an active screening approach by diabetes health care workers. Patients and methods: The initial 223 members of a cohort of 529 eligible diabetic subjects, aged 70 years or ove...

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Published in:	Diabetes research and clinical practice Vol. 61; no. 1; pp. 59 - 67
Main Authors:	Bruce, David G., Casey, Genevieve P., Grange, Valerie, Clarnette, Roger C., Almeida, Osvaldo P., Foster, Jonathan K., Ives, Franklyn J., Davis, Timothy M.E.
Format:	Journal Article
Language:	English
Published:	Shannon Elsevier Ireland Ltd 01-07-2003 Elsevier Science
Subjects:	Activities of Daily Living Age of Onset Aged Australia - epidemiology Biological and medical sciences Cognition Cognition Disorders - epidemiology Dementia Demography Depression Depression - epidemiology Diabetes Diabetes Mellitus - physiopathology Diabetes Mellitus - psychology Diabetes. Impaired glucose tolerance Disability Disabled Persons - statistics & numerical data Elderly Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Follow-Up Studies Health Surveys Humans Male Medical sciences Socioeconomic Factors Surveys and Questionnaires Time Factors Australia Disability Depression Diabetes Elderly Dementia Endocrinopathy Mood disorder Handicap Human Cognitive disorder Diabetes mellitus Cognition Epidemiology
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Summary:	Objective: To determine whether the prevalence of dementia, depression and/or disability in older diabetic subjects warrants an active screening approach by diabetes health care workers. Patients and methods: The initial 223 members of a cohort of 529 eligible diabetic subjects, aged 70 years or over, were screened for cognitive impairment (using the Mini-Mental State Examination (MMSE) and Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE)), physical impairments and depressive symptoms. Results: Virtually all subjects were community-dwelling (99%) and mobile (86%) and relatively few had moderate or severe deficits in activities of daily living (ADL) (17.5%). The prevalences of cognitive impairment and probable dementia estimated from the screening tests were high (range 10.8–17.5%) compared with population studies. Any deficit with ADL was reported by 53% of the subjects and common problems included urinary and faecal incontinence. Scores consistent with clinical depression were reported by 14.2% of the sample but 50.2% of the remainder reported one or more depressive symptoms below the cut-off point for clinical depression. Only 36% of the study subjects were free of deficits in any domain. Conclusions: Community-living older diabetic subjects have high rates of cognitive impairment, deficits in physical function and depressive symptomatology suggesting that screening programs for functional impairments and depression may be beneficial in health care systems that manage older diabetic patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0168-8227 1872-8227
DOI:	10.1016/S0168-8227(03)00084-6