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Prediction model for mild cognitive impairment in patients with type 2 diabetes using the autonomic function test

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Abstract

Objective

Type 2 diabetes mellitus (T2DM) is a risk factor for cognitive impairment, and reduced heart rate variability (HRV) has been correlated with cognitive impairment in elderly individuals. This study investigated risk factors and validated a predictive model for mild cognitive impairment (MCI) in patients with T2DM using an autonomic function test.

Methods

Patients with T2DM, 50–85 years of age, who attended the diabetes clinic at Gyeongsang National University Hospital between March 2018 and December 2019, were included. A total of 201 patients had been screened; we enrolled 124 patients according to the inclusion and exclusion criteria in this study. Cognitive function was assessed using the Montreal Cognitive Assessment-Korean version (MOCA-K); MCI was defined as a total MOCA-K score ≤ 23. Risk factors for MCI in patients with T2DM, including demographic- and diabetes-related factors, and autonomic function test results, were analyzed. Based on multivariate logistic regression, a nomogram was developed as a prediction model for MCI.

Results

Thirty-nine of 124 patients were diagnosed with MCI. Age, education, and decreased cardiovagal function were associated with a high risk for MCI, with cardiovagal function exerting the greatest influence. However, diabetes-related factors, such as glycemic control, duration of diabetes, or medications, were not associated with the risk for MCI. The nomogram demonstrated excellent discrimination (area under the curve, 0.832) and was well calibrated.

Conclusion

Approximately one-third of patients had MCI; as such, carefully evaluating cognitive function in elderly T2DM patients with reduced HRV is important to prevent progression to dementia.

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Data availability

The datasets used during current study available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Seung Chan Kim for advice on statistical analysis.

Funding

This research was funded by the Neurological Disorder Research Program of the National Research Foundation funded by the Korean Government (MSIT) (2020M3E5D9080663), the Lee Jung Ja research grant of Gyeongsang National University Hospital (LJJ-GNUH_2018-005), and grants from the Basic Science Research Program through the National Research Foundation of Korea (2021R1A2C2093913).

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Authors and Affiliations

  1. Department of Neurology, College of Medicine, Institute of Medical Science, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, 52727, Korea

    Heeyoung Kang

  2. Department of Neurology, Gyeongsang National University Hospital, Jinju, Korea

    Juhyeon Kim & Minkyeong Kim

  3. Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, Korea

    Jin Hyun Kim

  4. Department of Anatomy, College of Medicine, Institute of Medical Science, Gyeongsang National University, Jinju, Korea

    Gu Seob Roh

  5. Department of Internal Medicine, College of Medicine, Institute of Medical Science, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, 52727, Korea

    Soo Kyoung Kim

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Kang, H., Kim, J., Kim, M. et al. Prediction model for mild cognitive impairment in patients with type 2 diabetes using the autonomic function test. Neurol Sci (2024). https://doi.org/10.1007/s10072-024-07451-6

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