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العنوان
Impact of Cognitive Impairment and Psychiatric Illness on Glycemic Control in Egyptian Elderly Diabetics /
المؤلف
Rohaiem, Shaimaa Nabil Mohammed.
هيئة الاعداد
باحث / Shaimaa Nabil Mohammed Rohaiem
مشرف / Moatasem Salah Amer
مشرف / Randa Abd el Wahab Reda Mabrouk
مشرف / Tomader Taha Abdel Rahman
مناقش / Salma Mohamed Samir El Said
مناقش / Nermien Naem Adly
تاريخ النشر
2014.
عدد الصفحات
157. P.;
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
طب الشيخوخة وعلم الشيخوخة
تاريخ الإجازة
1/1/2014
مكان الإجازة
جامعة عين شمس - كلية الطب - Geriatric Medicine & Gerontology
الفهرس
Only 14 pages are availabe for public view

from 157

from 157

Abstract

The prevalence of Diabetes mellitus is growing rapidly in developing and even more in developed countries. The worldwide estimates of its prevalence are expected to rise.
Diabetes mellitus is a complex metabolic disease that has hazardous effects on many body organs. A less addressed and not as well recognized complication of diabetes is cognitive dysfunction and dementia.
Researchers are also being conducted to better understand why people with diabetes find self-management of their illness a challenge and to develop behavioral interventions to help older people improve their diabetes self-management. There is little research about effect of cognitive impairment associated with diabetes on people’s self-management.
The relationship between diabetes and psychiatric illnesses is an interesting topic for both internists and psychiatrists for many years. Diabetes and psychiatric disorders share a bidirectional association influencing each other in multiple ways .
People with diabetes are two-fold more likely to be diagnosed with depression as compared to people who do not have diabetes and Generalized anxiety disorder is present in 14% of patients with diabetes worldwide.
This thesis was conducted to assess the impact of cognitive impairment and psychiatric illness on glycemic control among elderly diabetics.
The study was done to assess the impact of cognitive impairment and psychiatric illness on glycemic control.
The study was performed on a sample of 100 elderly diabetic males and females 60 years and older. They were recruited from hospital wards and Diabetes Mellitus outpatient clinic; and divided into two groups; first group consisting of 50 subjects with controlled diabetes mellitus and the second 50 had uncontrolled diabetes mellitus (according to HbA1c)..
The 100 elderly were subjected to comprehensive geriatric assessment including personal history, past medical history, cognitive assessment using mini mental state examination (MMSE), Mattis Organic Mental Syndrome Screening Examination (MOMSSE), CAMCOG and Clock drawing test (CDT)
Depression assessment using geriatric depression scale (GDS), assessment of anxiety through DSM-IV criteria functional assessment using the activities and instrumental activities of daily living (ADL & IADL), laboratory investigations included; fasting blood sugar, postprandial blood sugar, lipid profile and glycated haemoglobin.
As we studied cognitive dysfunction with glycemic control, the study showed that CAM-COG score was significantly higher in controlled group. Also it showed that there was significant difference between the two groups as regard MMSE divided items score in orientation (higher in controlled group) and recall (higher in controlled group)
It showed that Orientation, Comprehension, Expression, Attention , and Abstraction of the CAMCOG divided items score were higher in patients with controlled diabetes than uncontrolled group.
It showed that there was a significant difference between the two groups as regard the MOMSSE below average and average scores, as the Below average score was more common in uncontrolled group, while the Average score was more common in the controlled group.
It showed that depression was more common among patients with uncontrolled diabetes and the difference was statistically significant.
As regard the relation between functional state and glycemic control there was a highly significant difference between the two groups regarding the Independent status and a significant difference between the two groups regarding the Assisted & Dependant status regarding ADL, on the other hand the IADL showed significant difference between the two groups as regard the Independent & dependant status.
There was a significant difference between the two groups as regard the ability for buying drugs and a highly significant difference as regard the ability for buying same brand name drugs; the application of treatment; and the follow up status.
Also, the study showed that there was a highly significant difference between the two groups as regard the levels of the total Cholesterol and Low density lipoprotein cholesterol; In addition there was a significant difference between the two groups as regard the Triglycerides level; But there was no significant difference between the two groups as regard the High density lipoprotein cholesterol.
Our study revealed that CAMCOG had better sensitivity and MOMSSE had better specificity in measuring cognition in the uncontrolled group.