Prevalence of cognitive impairment and its associated factors in type 2 diabetes mellitus patients with hypertension in Hunan, China: a cross-sectional study

Hongying Liu; Ziling Feng; Wenyan Zhang; Yamin Liu; Ni Xiong; Wenhang Chen; Jianzhou Yang; Xin Yin Wu; Zeya Shi; Wenjie Dai

doi:10.3389/fpsyt.2024.1445323

Prevalence of cognitive impairment and its associated factors in type 2 diabetes mellitus patients with hypertension in Hunan, China: a cross-sectional study

Front Psychiatry. 2024 Dec 19:15:1445323. doi: 10.3389/fpsyt.2024.1445323. eCollection 2024.

Authors

Hongying Liu¹, Ziling Feng², Wenyan Zhang², Yamin Liu², Ni Xiong², Wenhang Chen³, Jianzhou Yang⁴, Xin Yin Wu², Zeya Shi⁵, Wenjie Dai²

Affiliations

¹ Case Room, Medical Department, Hunan Prevention and Treatment Institute for Occupational Diseases, Affiliated Prevention and Treatment Institute for Occupational Diseases of University of South China, Changsha, Hunan, China.
² Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
³ Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
⁴ Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China.
⁵ Nursing Department, Hunan Prevention and Treatment Institute for Occupational Diseases, Affiliated Prevention and Treatment Institute for Occupational Diseases of University of South China, Changsha, Hunan, China.

Abstract

Background: Individuals with both type 2 diabetes mellitus (T2DM) and hypertension have an increased risk of cognitive impairment (CI) compared to those with either T2DM or hypertension. Therefore, this study aims to identify the prevalence of CI and its associated factors in T2DM patients with hypertension in Hunan, China.

Methods: This cross-sectional study included T2DM patients with hypertension admitted to the Department of Endocrinology of Yuanjiang People's Hospital in Hunan Province from July 2022 to February 2023. Data on sociodemographic, lifestyle, disease-related characteristics, and cognitive function were collected through face-to-face interviews. Cognitive function was assessed using the Mini-Mental State Examination. Backward stepwise multivariable logistic regression analysis was used to identify factors associated with CI. The predictive power was examined using the receiver operating characteristic (ROC) curve.

Results: A total of 475 participants were included. The prevalence of CI was 38.9% (95% confidence interval [95% CI]: 34.5%-43.3%). Multivariable logistic regression analysis showed that advanced age (odds ratio [OR]=3.21, 95% CI: 1.74-5.93), elementary school or below (OR=3.51, 95% CI: 1.19-10.31), per capita monthly household income ≤2000 RMB (OR=5.29, 95% CI: 2.66-10.51), not current reading books or newspapers (OR=4.48, 95% CI: 1.26-15.99), not current playing cards or mahjong (OR=3.52, 95% CI: 1.91-6.47), current average time of physical activity ≤30 minutes per day (OR=8.66, 95% CI: 4.65-16.12), diabetic nephropathy (OR=1.95, 95% CI: 1.05-3.61) and stroke (OR=7.41, 95% CI: 3.41-16.11) were associated with a higher risk of CI in T2DM patients with hypertension. The area under the ROC curve of this model was 0.925 (95% CI: 0.902-0.949).

Conclusions: The prevalence of CI was high in T2DM patients with hypertension in Hunan, China. Age, educational level, household income, current reading books or newspapers status, current playing cards or mahjong status, current average time of physical activity per day, diabetic nephropathy, and stroke were associated with CI in T2DM patients with hypertension.

Keywords: associated factors; cognitive impairment; hypertension; prevalence; type 2 diabetes mellitus.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Major Scientific Research Project of Hunan Health high-level Talents in 2023 (grant number R2023072), the National Natural Science Foundation of China under (grant number 82103939), the National Natural Science Foundation of Hunan Province under (grant number 2023JJ30734), the Start-up Research Fund of Central South University under (grant number 202044003), and the National Key R&D Program of China under (grant number 2020YFC2008600).