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Publications

Journal Article Epublish

PubMed: 39860569 DOI: 10.3390/jcm14020563

Relationship Between Depression and Decreased Activity Level and Cognitive Impairment in Patients with Diabetes Mellitus Type 2 and/or Atrial Fibrillation.

J Clin Med 14(2)

Authors: Marius Militaru, Daniel Florin Lighezan, Cristina Tudoran, Flavia Zara, Adina Bucur, Anda Gabriela Militaru

Affiliations

  • Department of Neuroscience, Discipline of Neurology II, University of Medicine and Pharmacy "Victor Babes", E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
  • Emergency City Hospital Timisoara, Gheorghe Dima Street, Nr. 5, 300254 Timisoara, Romania.
  • Centre of Advanced Research in Cardiology and Hemostasology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
  • Department of Internal Medicine I, Discipline of Medical Semiology I, University of Medicine and Pharmacy "Victor Babes", E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
  • Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
  • Centre of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
  • County Emergency Hospital "Pius Brinzeu", L. Rebreanu, Nr. 156, 300723 Timisoara, Romania.
  • Department of Microscopic Morphology, University of Medicine and Pharmacy "Victor Babes", E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
  • Department of Pathology, Emergency City Hospital, Gheorghe Dima Street, Nr. 5, 300254 Timisoara, Romania.
  • Department of Functional Sciences, Discipline of Public Health, Centre for Translational Research and Systems Medicine, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.

Abstract

The interdependence between type 2 diabetes mellitus (DM-2), atrial fibrillation (AF), and cognitive decline (CD)/dementia is a debated topic. In this study, we highlighted the influence of DM-2 and FA individually and in association on the severity of CD/dementia. This study comprises 248 patients with very high cardiovascular risk (VHCVR) according to Systematic Coronary Risk Evaluation (SCORE2), of whom 184 had DM-2 and/or AF, and 64 were age-matched controls (without DM-2/AF), admitted to the Municipal Hospital Timisoara. Mini-Mental-State-Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living Score (ADL), and Instrumental Activities of Daily Living Score (IADL) were significantly decreased, and Geriatric Depression Scale (GDS-15) increased in patients with DM-2 and AF in comparison to controls ( < 0.05), with the subjects with DM-2 and AF having more severe CD compared to those with only one of these two pathologies. The logistic regression model showed that the risk of CD (MMSE < 27) or dementia (MMSE < 24) increased significantly in patients with DM-2 and/or AF depending on the SCORE2 values, ADL, and GDS-15. In DM-2 and/or AF patients, an increase of 1% in SCORE2 was associated with an elevation of 2.40% in the odds of CD and of 4.30% of dementia. In these patients, depression (GDS score) increased the risk of CD by 36.3%, and if ADL improved, the risk of CD decreased by 44.0%. Our findings suggest a direct association between CD, DM-2, and AF with SCORE2, cognitive parameters, ADL, and depression. In patients with DM-2 and/or AF, it is important to identify subclinical CD to prevent the evolution to dementia.

MeSH

Diabetes Mellitus, Depression, Activities Of Daily Living, Dementia, Cognitive Dysfunction, Atrial Fibrillation, Cognition Disorders, Mental Status And Dementia Tests, Diabetes Mellitus, Type 2

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