Cognitive impairment and associated factors among adult diabetes mellitus patients in Amhara National Regional State referral hospitals, Ethiopia: a multicenter institution-based cross-sectional study

Cognitive impairment is characterized by compromised cognitive function in one or more domains. Nonetheless, it has devastating health and socioeconomic burdens on diabetic patients worldwide, and studies conducted, especially in Ethiopia, are not large enough. This study aimed to assess the prevalence of cognitive impairment and its associated factors among adult diabetes mellitus patients in Amhara National Regional State Referral Hospitals, Ethiopia. A multicenter institution-based cross-sectional study was conducted with 415 study participants at referral Hospitals in Amhara National Regional State between May 1 and June 10, 2022. The sample was selected using a simple and systematic random sampling technique. Data were collected using a pretested structured interviewer-administered questionnaire. Cognitive impairment was assessed using standardized Mini-Mental State Examination (MMSE) tool. Epi data 4.6 and STATA (14.0) were used for data entry and analysis, respectively. Bivariable and multivariable logistic regression, odds ratios, and with 95% confidence interval (CI) at a p-value of ≤ 0.05 was used to declare significantly associated variables. The magnitude of cognitive impairment among adult diabetes mellitus patients was 46.27%, with 95% CI (41.5%, 51.1%). No formal education (AOR = 4.81, 95% CI:1.54, 15); older age > 60 years (AOR = 3.91, 95% CI:1.6, 7.9), current alcohol drinking (AOR = 2.64, 95% CI: 1.13, 6.18), physical activity (AOR = 0.44, 95% CI:0.22, 0.89), fasting blood sugar (FBS) > 130 mg/dl (AOR = 4.69, 95% CI: 2.61, 8.41), hypoglycemia episode (AOR = 2.87, 95% CI: 1.62, 5.06), insulin treatment (AOR = 3.76, 95% CI: 1.94, 7.27), body mass index (BMI) ≥ 30 kg/m2 (AOR = 3.3, 95% CI:1.03, 10.56) were variables significantly associated with cognitive impairment. Nearly, half of the study participants had cognitive impairment. No formal education, older age > 60 years, current alcohol drinking, physical activity, FBS > 130 mg/dl, hypoglycemia episode, insulin treatment, and BMI ≥ 30 kg/m2 were significantly associated with cognitive impairment. Healthcare providers are recommended to routinely screen diabetic patients during follow-up and, frequently follow cognitively impaired and high-risk groups.