Prevalence, domains and factors associated with cognitive impairment among diabetes mellitus patients attending Kayunga Regional Referral Hospital, Uganda

Cognitive impairment is a common but underrecognized complication among patients with diabetes mellitus (DM). In Africa, its prevalence ranges from 34% in Egypt to 88.5% in Nigeria. This study aimed to determine the prevalence, domains, and factors associated with cognitive impairment among diabetic patients attending Kayunga Regional Referral Hospital (KRRH). We conducted a hospital-based analytical cross-sectional study among adults aged ≥ 18 years with a diagnosis of DM for > 3 months and or on regular follow-up at KRRH. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with a score < 26/30 indicating cognitive impairment. Sociodemographic, clinical, and behavioural data were collected using structured questionnaires. Statistical analyses were performed using SPSS v26, and logistic regression identified factors independently associated with cognitive impairment. Statistical significance was set at p < 0.05. A total of 377 participants were enrolled, 233 (61.8%) were female, and 267 (70.8%) were middle-aged. Cognitive impairment was present in 189 (50.1%) participants. The most affected cognitive domain was attention and calculation, while language, orientation, and repetition were least affected. Independent predictors of cognitive impairment included age ≥ 65 years (aOR = 2.82; 95% CI: 1.47-5.39; p = 0.002), low education level (aOR = 1.76; 95% CI: 1.03-3.01; p = 0.038), being divorced (aOR = 2.15; 95% CI: 1.05-4.43; p = 0.035), history of smoking (aOR = 2.46; 95% CI: 1.22-4.94; p = 0.012), poor medication adherence (aOR = 2.94; 95% CI: 1.59-5.42; p = 0.001), and lack of diabetes counselling (aOR = 2.21; 95% CI: 1.16-4.21; p = 0.016). Cognitive impairment was highly prevalent among diabetic patients, affecting half of the study participants. Routine cognitive screening should be integrated into diabetic care to allow early detection and intervention. Counselling focused on adherence and smoking cessation is essential to mitigate cognitive decline.