Impact of treatment modality on cognition in older adults with type 2 diabetes mellitus.

Introduction: Cognitive impairment impacts functionality and health outcomes in older adults with diabetes mellitus. Crucially, managing diabetes involves many self-management activities that require adequate cognitive abilities. Pharmacological therapy for diabetes mellitus in older persons should address both cognitive functions and glycaemic control. Objective: To examine the relationship between the treatment modality of diabetes and cognitive functions in the elderly. Methodology: A cross-sectional hospital-based study of older adults with type 2 diabetes mellitus over 1 year was conducted. Sociodemographic, relevant clinical details were obtained; Mini-Mental Status Examination (MMSE), Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), Trail-Making B test, F-A-S fluency, and categorical fluency test were assessed. Descriptive statistics, a generalized linear model, and a structural equation model with path analysis were performed to understand the relationship between treatment modality for diabetes and cognitive functions in the elderly. Results: A total of 134 diabetic patients with a mean age of 68.06 + 6.29 years were assessed. The oral hypoglycaemic agent (OHA) treatment group has significantly better glycaemic control than the insulin group (P value < 0.001). The OHA treatment group performed significantly better in DSST, Trail-Making B test, F-A-S fluency, categorical fluency, and RAVLT (delayed recall, immediate memory). The OHA treatment group has a significant association with all cognitive test scores except DSST, RAVLT immediate memory, and learning which is further strengthened with SEM analysis. Conclusion: Compared to insulin, OHA has a beneficial effect on cognition in older adults with type 2 diabetes mellitus.