Original Article

Effect of Dapagliflozin Combined with Cognitive Behavior Training on Quality of Life and Cognitive Function in Elderly Patients with Type 2 Diabetes Mellitus Complicated with Mild Cognitive Impairment

Abstract

Background: To investigate the effect of dapagliflozin combined with cognitive behavior training on quality of life and cognitive function in elderly patients with type 2 diabetes mellitus (T2DM) complicated with mild cognitive impairment.

Methods: Ninety-six elderly patients with T2DM and mild cognitive impairment treated in Shenzhen People’s Hospital, Guangdong Province China from June 2019 to December 2020 were selected and equally randomized into control group (CG) and experimental group (EG). The CG received conventional intervention, while the EG received dapagliflozin combined with cognitive behavior training based on the CG. The clinical observation indexes of both groups were compared to assess the clinical intervention effect of dapagliflozin combined with cognitive behavior training on elderly patients with T2DM complicated with mild cognitive impairment.

Results: After intervention, the blood glucose levels of both groups decreased, and compared with the CG, the blood glucose level of the EG was markedly lower (P<0.05). The scores of C-DMSES, ADL and MMSE of both groups were higher than those before intervention, and compared with the CG, the scores of the EG were obviously higher (P<0.05). The QOL-AD scores of both groups gradually increased, and compared with the CG, the QOL-AD scores of the EG were higher at 3 and 6 months after intervention (P<0.05).

Conclusion: For elderly patients with T2DM complicated with mild cognitive impairment, dapagliflozin combined with cognitive behavior training intervention can obviously improve their cognitive function, self-efficacy of diabetes management and quality of life, which should be promoted in clinic.

 

1. Muhammad A, Quratulain S, Scahill S (2018). Depression and mild cognitive impairment (MCI) among elderly patients with type 2 diabetes mellitus in Pakistan: possible determinants. Int J Diabetes Devel-oping Countries, 38(3): 312-320.
2. Gao Y, Xiao Y, Miao R, Zhao J, Cui M, Huang G, Fei M (2016). The prevalence of mild cognitive impairment with type 2 diabetes mellitus among elderly people in China: A cross-sectional study. Arch Ger-ontol Geriatr, 62(1): 138-142.
3. Mansur RB, Lee Y, Zhou AJ, et al (2018). Determinants of cognitive function in in-dividuals with type 2 diabetes mellitus: A meta-analysis. Ann Clin Psychiatry, 30(1): 38-50.
4. Hughes T, Sink K, Williamson J, et al (2018). Relationships between cerebral structure and cognitive function in African Ameri-cans with type 2 diabetes. J Diabetes Com-plications, 32(10):916-921.
5. Alagiakrishnan K, Zhao N, Mereu L, Senior P, Senthilselvan A (2013). Montreal Cog-nitive Assessment Is Superior to Stand-ardized Mini-Mental Status Exam in De-tecting Mild Cognitive Impairment in the Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus. Biomed Res Int, (Pt.12): 186106-186110.
6. Du B, Lian Y, Chen C, Zhang H, Bi Y, Fan C, Bi X (2019). Strong Association of Se-rum GSK-3 beta/BDNF Ratio with Mild Cognitive Impairment in Elderly Type 2 Diabetic Patients. Curr Alzheimer Res, 16(12): 1151-1160.
7. Gao Y, Xiao Y, Miao R, et al (2015). The characteristic of cognitive function in Type 2 diabetes mellitus. Diabetes Res Clin Pract, 109(2): 299-305.
8. Cruz-Grullon M, Castejon-Hernez S, Morel-Corona FJ, et al (2019). P-493: Prescrip-tion review in older patients with type-2 diabetes mellitus at intermediate care hospital. Eur Geriatr Med, 10(suppl.1): S191.
9. Vieira RN, Ávila R, de Paula JJ, et al (2016). Association between DCHS2 gene and mild cognitive impairment and Alzhei-mer's disease in an elderly Brazilian sam-ple. Int J Geriatr Psychiatry, 31(12): 1337-1344.
10. Vieira RN, Ávila R, de Paula JJ, et al (2014). Mild Cognitive Dysfunction Does Not Affect Diabetes Mellitus Control in Mi-nority Elderly Adults. Int J Geriatr Psychia-try, 62(12): 2363-2368.
11. Kim TE, Lee DH, Kim YJ, et al (2015). The relationship between cognitive perfor-mance and insulin resistance in non‐diabetic patients with mild cognitive im-pairment. Int J Geriatr Psychiatry, 30(6): 551-557.
12. Borzì AM, Condorelli G, Biondi A, et al (2019). Effects of vildagliptin, a DPP-4 inhibitor, in elderly diabetic patients with mild cognitive impairment. Arch Gerontol Geriatr,84: 103896.
13. Hosny SS, Bahaaeldin AM, Khater MS, Bekhet MM, Hebah HA, Hasanin GA (2019). Role of Inflammatory Markers in Elderly Type 2 Diabetic Patients with Mild Cognitive Impairment. Curr Diabetes Rev, 15(3): 247-253.
14. Yanagawa M, Umegaki H, Uno T, et al (2011). Association between improve-ments in insulin resistance and changes in cognitive function in elderly diabetic patients with normal cognitive function. Geriatr Gerontol Int, 11(3): 341-347.
15. TW, Ng GYF, Chung RCK, Ng SSM. (2019). Decreasing Fear of Falling in Chronic Stroke Survivors Through Cog-nitive Behavior Therapy and Task-Oriented Training. Stroke, 50(1): 148-154.
16. Velligan DI, Tai S, Roberts DL, et al (2015). A Randomized Controlled Trial Compar-ing Cognitive Behavior Therapy, Cogni-tive Adaptation Training, Their Combina-tion and Treatment as Usual in Chronic Schizophrenia. Schizophr Bull, 41(3): 597-603.
17. Lusk P, Hart Abney BG, Melnyk BM. (2018). A Successful Model for Clinical Training in Child/Adolescent Cognitive Behavior Therapy for Graduate Psychiat-ric Advanced Practice Nursing Students. J Am Psychiatr Nurses Assoc, 24(5): 457-468.
18. Jane S. Saczynski, Jennifer A. Margrett, Sher-ry L. Willis (2004). Older Adults’ Strategic Behavior: Effects Of Individual Versus Collaborative Cognitive Training. Edu Gerontol, 30(7): 587-610.
19. Forman EM, Goldstein SP, Flack D, et al (2018). Promising technological innova-tions in cognitive training to treat eating-related behavior. Appetite, 124: 68-77.
20. Sun B, Ren J (2016). Motor behavior affects serum BDNF, MG and cognitive func-tion in elderly patients with T2DM. Diabe-tes/metab Res Rev, 32(Suppl.2): 37.
21. Sung J, Woo JM, Kim W, Lim SK, Chung EJ (2012). The Effect of Cognitive Be-havior Therapy-Based “Forest Therapy” Program on Blood Pressure, Salivary Cortisol Level, and Quality of Life in El-derly Hypertensive Patients. Clin Exp Hy-pertens, 34(1): 1-7.
22. Rascón-Martínez DM, Fresán-Orellana A, Ocharán-Hernández ME, et al (2016). The Effects of Ketamine on Cognitive Function in Elderly Patients Undergoing Ophthalmic Surgery: A Pilot Study. Anesth Analg, 122(4): 969-975.
23. Zhang Y, Cai J, An L, Hui F, Ren T, Ma H, Zhao Q (2017). Does music therapy en-hance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Ageing Res Rev, 35: 1-11.
24. Prochota B, Szwamel K, Uchmanowicz I (2019). Socio-clinical variables affecting the level of self-care in elderly patients with heart failure. Eur J Cardiovasc Nurs, 18(7): 628-636.
25. Richard-Devantoy S, Jollant F, Kefi Z, et al (2012). Deficit of cognitive inhibition in depressed elderly: A neurocognitive marker of suicidal risk. J Affect Disord, 140(2): 193-199.
Files
IssueVol 51 No 6 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i6.9668
Keywords
Dapagliflozin Cognitive behavior training Elders Type 2 diabetes mellitus
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Zhao Y, Zhang R, Wang S. Effect of Dapagliflozin Combined with Cognitive Behavior Training on Quality of Life and Cognitive Function in Elderly Patients with Type 2 Diabetes Mellitus Complicated with Mild Cognitive Impairment. Iran J Public Health. 2022;51(6):1251-1258.