Title: Assessment of Executive Function in Type 2 Diabetes Mellitus – A Case Control Study
Authors: Dr V. Mythili, Dr V.Sabitha, Dr M. Shanthi Maheshwari
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.73
Abstract
There is growing evidence that adults with type 2 Diabetes mellitus exhibit deficits in executive function. Primary purpose of this study was to assess executive function in type 2 DM patients. The age group studied was between 40-50 years and it was compared with the healthy controls. This is a cross sectional case control study, where in 50 consenting patients attending diabetology Outpatient department fulfilling the inclusion criteria were randomly chosen as cases and 50 consenting age, sex, education matched non diabetics were taken as controls. After screening with General Health Questionaire – 12 for psychiatric symptoms, Executive function was assessed with Digit Span Test, Verbal fluency test, Trail making test, Wisconsin Card Sorting Test and Stroop Test. In our study we found that here was no significant difference between diabetic and non-diabetic group in case digit span, verbal fluency, stroop test and WCST. There was a statistically significant difference between case and control group in Trail Making Test (p = 0.01). There was average difference of 8 seconds between diabetic and non- diabetics. The Stroop test showed a similar slowing in diabetics of 3 seconds but it was not statistically significant. Executive functioning in diabetics was comparable to that of control group. Though Trail making test, showed a statistical difference between diabetics and non-diabetic, it was still within the normative range for the particular age group.
Keywords: Executive functions, Type 2 Diabetes, Stroop test, Wisconsin Card Sorting Test.
References
1. Ha T. Nguyen, Ph.D.,1 Joseph G. Grzywacz, Ph.D et al. Linking Glycemic Control and Executive Function in Rural Older Adults with Diabetes. J Am Geriatr Soc. Jun 2010; 58(6): 1123–1127.
2. Royall DR, Lauterbach EC, Cummings JL, et al. Executive control: a review of its promise and challenges for clinical research. J.Neuropsychiatry Clin Neurosci 2002; 14: 377-405.
3. Schillerstrom JE, Horton MS, Royall DR. The impact of medical illness on executive function. Psychosomatics 2005; 46: 508-516 .
4. Gregg EW, Beckles GL, Williamson DF, et al Diabetes and physical disability among older U.S. adults. Diabetes Care. 2000;23:1272–1277.
5. Royall DR, Chiodo LK, Polk MJ. An empiric approach to level of care determinations: the importance of executive measures. J Gerontology 2005; 60: 1059-1064.
6. Sherifa A. Hamed. Diabetes Mellitus and the Brain: Special Emphasis to Cognitive Function -Review Article. International Journal of Diabetology & Vascular Disease Research(IJDVR).- 2013, Volume I Issue No.8
7. Awad N, Gagnon M, Messier C. The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive function. J Clin Exp Neuropsychol. 2004 Nov;26(8):1044-80. Review.
8. Messier C. Glucose improvement of memory: a review. Eur J Pharmacol. 2004 Apr 19;490(1-3):33-57
9. Ryan CM, Geckle MO. Circumscribed cognitive dysfunction in middle-aged adults with type 2 diabetes. Diabetes Care 2000; 23: 1486 – 149
10. Stewart R, Liolitsa D. Type 2 diabetes mellitus, cognitive impairment and dem-entia. Diabetic Medicine 1999; 16: 93-112
11. Nilsson E. Diabetes and cognitive functi-oning: The role of age and comorbidity. 2006 Unpublished doctoral dissertation, Karolinska Institutet, Stockholm.
12. Bennett D. A., Schneider J. A., Arvanitakis Z., Kelly J. F., Aggarwal N. T., Shah R. C., et al. (2006a). Neurop-athology of older persons without cogn-itive impairment from two community based studies. Neurology 66 1837–1844
13. Arvanitakis Z, Wilson RS, Bennett DA. Diabetes mellitus, dementia and cognitive function in older persons. J Nutrition, Health & Aging 2006; 10: 287-291
14. Changes in cognitive abilities over a 4-year period are unfavorably affected in elderly diabetic subjects: results of the Epidemiology of Vascular Aging Study.Fontbonne A1, Berr C, Ducimetière P, Alpérovitch A.
15. Verdelho A, Madureira S, Moleiro C, Ferro JM, Santos CO, Erkinjuntti T, Pantoni L, Fazekas F, Visser M, Waldemar G, et al: White matter changes and diabetes predict cognitive decline in the elderly: the LADIS study. Neurology 2010;75:160–167.
16. Versluis CE, van der Mast RC, van Buchem MA, Bollen EL, Blauw GJ, Eekhof JA, van der Wee NJ, de Craen AJ: Progression of cerebral white matter lesions is not associated with development of depressive symptoms in elderly subjects at risk of cardiovascular disease: the PROSPER Study. Int J Geriatr Psychiatry 2006;21:375–381.
Dr V.Sabitha
Associate Professor
Institute of Mental Health, Kilpauk, Chennai: 10