Assessment of executive functions in type II diabetes patients with focus on duration of diabetes: preliminary findings of an analytical cross-sectional study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20233387Keywords:
Executive function, Diabetes mellitus, DurationAbstract
Background: Executive functions have been defined as one’s ability to plan, initiate, sequence, monitor, and inhibit complex behaviour. Executive functions are purportedly affected significantly in diabetes population; duration of diabetes having particularly negative impact. Present study was undertaken to determine whether executive functions are affected more in diabetic patients as compared to non-diabetics and to further assess the role duration of diabetes.
Methods: In this analytical, cross-sectional study being conducted over 18 months period at a tertiary-care private teaching hospital in Central India, 148 participants (74 in diabetic & 74 in non-diabetic group) between the age of 30-60 years are enrolled. Preliminary data of 50 patients is presented here. The executive functions were assessed by using Delis-Kaplan Executive function system and participants was subjected to Trail making test, Design fluency test, Tower test and DKEF sorting test and the scores were compared between the two groups.
Results: Statistically significant differences were observed for Trail making test (median value diabetic-7 vs. non-diabetic-10), Design fluency test (median value diabetic-10 vs. non-diabetic-10, the range varied significantly), Tower test (median value diabetic-5 vs. non-diabetic-9), DKEF sorting test (median value diabetic-7 vs. non-diabetic-8) and Sort recognition test (median value- diabetic-6 vs. non-diabetic-8). The duration of diabetes exhibited strong, statistically significant negative correlation with the four studied parameters and had weak, insignificant positive correlation with sort recognition DS.
Conclusions: Executive functions are significantly affected in adult diabetes patients as compared to non-diabetic population and duration of diabetes has major contributory role in this affection.
References
Gilbert SJ, Burgess PW. Executive function. Curr Biol. 2008;18(3):R110-4.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington DC: American Psychiatric Association; 1994.
Sudo FK, Amado P, Alves GS, Laks J, Engelhardt E. A continuum of executive function deficits in early subcortical vascular cognitive impairment: A systematic review and meta-analysis. Dementia Neuropsychol. 2017;11:371-80.
Kim SY, Karlawish JH, Caine ED. Current state of research on decision-making competence of cognitively impaired elderly persons. Am J Geriatr Psychiatr. 2002;10(2):151-65.
Okereke OI, Kang JH, Cook NR, Gaziano JM, Manson JE, Buring JE, et al. Type 2 diabetes mellitus and cognitive decline in two large cohorts of community‐dwelling older adults. J Am Geriatr Soc. 2008;56(6): 1028-36.
Fontbonne A, Berr C, Ducimetière P, Alpérovitch A. Changes in cognitive abilities over a 4-year period are unfavourably affected in elderly diabetic subjects: results of the Epidemiology of Vascular Aging Study. Diab Care. 2001;24(2):366-70.
Qiao QW, Lyn PL, Hibberd P, Buell J, Collins L, Leins D, et al. Executive dysfunction in homebound older people with diabetes mellitus. J Am Geriatr Soc. 2006; 54(3):496-501.
Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. Available at: https://apps.who.int/iris/ bitstream/handle/10665/43588/924159?sequence=1. Accessed on 5 July 2023.
Mythili V. Assessment of Executive Function in Type 2 Diabetes Mellitus: A Case Control study (Doctoral dissertation, Madras Medical College, Chennai). Available at: http://repository-tnmgrmu.ac.in/7506/. Accessed on 5 July 2023.
Delis DC, Kaplan E, Kramer JH. Delis-Kaplan executive function system. Available at: https:// psycnet.apa.org/doiLanding?doi=10.1037%2Ft15082-000. Accessed on 5 July 2023.
Perry RE, Braren SH, Rincón-Cortés M, Brandes-Aitken AN, Chopra D, Opendak M, Alberini CM, Sullivan RM, Blair C. Enhancing executive functions through social interactions: Causal evidence using a cross-species model. Front Psychol. 2019;24:72.
Zhang H, Xiong RH, Sara H, Zhang JJ, Zhang XQ. Psychological distress, family functioning, and social support in family caregivers for patients with dementia in the mainland of China. Chinese Med J. 2013; 126(18):3417-21.
Teixeira MM, Passos VMA, Barreto SM, Schmidt MI, Duncan BB, Beleigoli AMR, et al. Association between diabetes and cognitive function at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA- Brasil). Sci Rep. 2020;10(1):1596.
Vincent C, Hall PA. Executive function in adults with type 2 diabetes: a meta-analytic review. Psychosomat Med. 2015;77(6):631-42.
Mansur RB, Lee Y, Zhou AJ, Carmona NE, Cha DS, Rosenblat JD, et al. Determinants of cognitive function in individuals with type 2 diabetes mellitus: A meta-analysis. Ann Clin Psychiatr. 2018;30(1):38-50.
Yeung SE, Fischer AL, Dixon RA. Exploring effects of type 2 diabetes on cognitive functioning in older adults. Neuropsychol. 2009;23(1):1.
Pereira FS, Yassuda MS, Oliveira AM, Forlenza OV. Executive dysfunction correlates with impaired functional status in older adults with varying degrees of cognitive impairment. Int Psychogeriatr. 2008; 20(6):1104-15.
Thabit H, Kyaw Tun T, McDermott J, Sreenan S. Executive function and diabetes mellitus-a stone left unturned?. Curr Diab Rev. 2012;8(2):109-15.
