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Risk factors associated with abnormal cognition in Japanese outpatients with diabetes, hypertension or dyslipidemia

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Abstract

Aims

According to the recent increase in life expectancy in patients with diabetes, the incidence of dementia with diabetes is increasing drastically in Japan. However, the number of studies on the prevalence of abnormal cognition and the associated risk factors in a large number of outpatients with diabetes in a primary care setting is very limited.

Methods

The Mini-Mental State Examination (MMSE) test was performed in 1,449 outpatients aged ≥50 years with diabetes, hypertension or dyslipidemia (126 without and 1,323 with diabetes). Prevalence of abnormal cognition defined as an MMSE score <24 and the associated risk factors were explored.

Results

Prevalence of abnormal cognition was 5.8 % in total, and was 8.3 % in outpatients aged ≥65 years with diabetes. Logistic regression analysis after adjustment for age, sex, BMI and smoking indicated that abnormal cognition was associated with lower serum albumin and higher uric acid levels in all subjects. In subjects with diabetes, in addition to the associations with serum albumin and uric acid levels, lower renal function, retinopathy, use of insulin and α-glucosidase inhibitor, and non-use of pioglitazone and metformin were significantly associated with abnormal cognition independent of the effect of duration of diabetes, hypertension, dyslipidemia, and history of coronary heart disease and stroke.

Conclusions

Because of the higher prevalence of abnormal cognition in aged outpatients with diabetes found in primary care practice and significant associations with serum albumin, uric acid, renal function, retinopathy and antidiabetic drugs, there is a need for early diagnosis and strategies against dementia.

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Acknowledgments

The authors thank Suguho Takahashi, Internal Medicine, Jiyugaoka Medical Clinic, Obihiro, for collecting the data in the study.

Duality of interest

M.H. received lecture fees from Boehringer Ingelheim GmbH, Mitsubishi Tanabe Pharma Corp., Novo Nordisk Pharma Ltd., Daiichi-Sankyo Co., Ltd., Taisho Pharmaceutical Co., Ltd., Sanofi K.K., Merck Sharp & Dohma, Astellas Pharma Inc., Kyowa Hakko Kirin Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Novartis Pharma K.K., and research grants from Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., Mitsubishi Tanabe Pharma Corp., Novo Nordisk Pharma, Ltd., Takeda Pharmaceutical Co., Merck Sharp & Dohma, Boehringer Ingelheim GmbH, and Eli Lilly. Others declare no conflict of interest. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent or a substitute for it was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Internal Medicine, Jiyugaoka Medical Clinic, West 6, South 6-4-3, Obihiro, 080-0016, Obihiro, Japan

    Hiroki Yokoyama, Mayumi Ogawa, Jun Honjo, Shinichiro Okizaki, Daishiro Yamada, Ryushi Shudo, Hitoshi Shimizu & Hirohito Sone

  2. Department of Medicine, Asahikawa Medical University, Asahikawa, Japan

    Jun Honjo & Masakazu Haneda

  3. Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, Sagamihara, Japan

    Shinichiro Okizaki

  4. Department of Internal Medicine, Faculty of Medicine, Niigata University, Niigata, Japan

    Hirohito Sone

Authors
  1. Hiroki Yokoyama
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  2. Mayumi Ogawa
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  3. Jun Honjo
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  4. Shinichiro Okizaki
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  7. Hitoshi Shimizu
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  8. Hirohito Sone
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  9. Masakazu Haneda
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Corresponding author

Correspondence to Hiroki Yokoyama.

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Yokoyama, H., Ogawa, M., Honjo, J. et al. Risk factors associated with abnormal cognition in Japanese outpatients with diabetes, hypertension or dyslipidemia. Diabetol Int 6, 268–274 (2015). https://doi.org/10.1007/s13340-014-0194-7

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  • DOI: https://doi.org/10.1007/s13340-014-0194-7

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