Abstract
BACKGROUND AND AIMS: The burden of cognitive impairment (CI) is high in diabetes mellitus. CI can adversely affect the self-care and management of diabetes, which results in an increase in the risk of hypo- or hyperglycaemic events and diabetic complications. The study aimed to determine the prevalence and predictors of CI in diabetic patients. METHODS: A hospital-based, cross-sectional study was conducted among diabetic patients who were attending Jinja Regional Referral Hospital (JRRH), Eastern Uganda, from April to June 2024. A pre-designed data collection tool was used to capture socio-demographics and clinic profiles of the participants. A Montreal Cognitive Assessment (MoCA), version 8.1, was used to assess the CI (score: ≥ 26 = normal, < 26 = cognitive impairment) in diabetic patients. We used a binary and multiple logistic regression analysis to identify predictors of CI in diabetes. RESULTS: The prevalence of CI among diabetic patients was 63.11% (95% CI: 58.3-67.9), and it was high among Type II diabetic patients (66.96%). Most of the patients have mild CI (73.77%). Delayed recall (78.96%) and language (73.77%) cognitive domains were greatly affected. Variables like advanced age (AOR = 6.08; 95% CI = 2.05-18.03), education (Illiterate: AOR = 5.90; 95% CI = 2.16-16.14; primary: AOR = 17.07; 95% CI = 5.64-51.71), alcohol use (AOR = 2.56; 95% CI = 1.22-5.37), no physical activity (AOR = 5.24; 95% CI = 2.52-10.91), type II diabetes (AOR = 7.02; 95% CI = 2.17-22.64), duration of diabetes (5-10 years: AOR = 14.09; 95% CI = 5.75-34.55; > 10 years: AOR = 78.80; 95% CI = 23.79-260.95), uncontrolled blood glucose (AOR = 5.13; 95% CI = 1.91-13.83), hypertension (AOR = 5.26; 95% CI = 2.08-13.34), and diabetic complications (AOR = 4.30; 95% CI = 1.38-13.36) were significantly associated with CI among diabetic patients. CONCLUSION: The study concludes that more than half of the diabetic patients had CI. Factors such as age, education, alcohol use, physical activity, diabetes type, duration of diabetes, glycaemic control, hypertension, and diabetic complications were significantly associated with CI in diabetes. Therefore, the study recommends planning and implementing management strategies that focus on predictors of CI in diabetes.