Cognitive impairment in type 2 diabetes mellitus – Cause or consequence of drug non-adherence

ABSTRACT Context: Diabetes mellitus is a major risk factor for cognitive impairment in India. Screening for cognitive impairment is necessary in diabetic patients as it may pose risk of non-adherence to medication, which may lead to grave consequences. Aims: The objectives of the study were to estimate the cognitive impairment in patients with type 2 diabetes mellitus (T2DM) using Mini-Cog as a screening tool, to assess medication adherence using the Morisky Medication Adherence scale (MMSA-8), and to determine any association between drug adherence and cognitive impairment. Settings and Design: Hospital-based cross-sectional analytical study. Methods and Material: A 3-minute Mini-Cog screening test was performed on patients with T2DM in the age group of 35–70 years attending the General Medicine Outpatient Department of Government General Hospital during the study period (3 months). Self-reported medication adherence was measured using the MMAS-8. Statistical analysis: T test and Pearson correlation test were used to find the association between the variables and cognitive impairment. A P value < 0.05 was considered statistically significant. Results: Out of the 100 participants, about 10% had cognitive impairment (Mini-Cog score ≤ 2). About 38%, 44%, and 18% of the study population had high, medium, and low adherence, respectively, using MMAS-8. The mean MMAS-8 score was significantly higher (lower adherence) among participants with cognitive impairment ( P = 0.012). Conclusions: Routine screening of cognitive impairment in diabetic patients using a simple 3-minute screening tool such as Mini-Cog test may assist in early detection, prompting necessary steps for evaluation and referral.