Abstract
BACKGROUND: This study aimed to investigate the risk factors associated with cognitive impairment in patients with T2DM, providing a basis for prevention and treatment. METHODS: This cross-sectional study involved adults aged 18 years and older who have T2DM. Participants were required to have available laboratory data and to be free of serious cognitive or neurological disorders. Demographic and clinical information was gathered through interviews, and cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with scores below 26 indicating cognitive impairment. RESULTS: Among the 229 participants (101 men and 128 women), 213 (93%) were found to have cognitive impairment. The mean age ± standard deviation at recruitment was 63.43 ± 10.37 years, and the median duration of diabetes was 11.00 years (interquartile range:6.00-16.00 years). Demographic, anthropometric, and biochemical variables did not vary significantly between the two groups, except for diabetes duration and low-density lipoprotein cholesterol (LDL-C) levels (p < 0.05). In the multivariate logistic regression analysis, only diabetes duration was independently associated with cognitive impairment (odds ratio [OR]:1.188; 95% confidence interval [CI]:1.048-1.348; P = 0.007). The optimal cut-off for diabetes duration in predicting cognitive impairment was found to be 8.5 years (area under the curve [AUC]:0.693; sensitivity: 64.3%, specificity:75.0%). CONCLUSION: Longer duration of diabetes is independently associated with an increased risk of cognitive impairment, with each additional year increasing the odds of cognitive decline by 18%. These findings underscore the importance of cognitive monitoring in individuals with diabetes, particularly those who have had the condition for more than 8.5 years, to facilitate early detection and intervention.