Depression and mild cognitive impairment (MCI) among elderly patients with type 2 diabetes mellitus in Pakistan: possible determinants

This descriptive, cross-sectional, questionnaire-based study was designed to assess the extent of depression and mild cognitive impairment (MCI) and their possible determinants among the elderly with type 2 diabetes mellitus in Pakistan. The study was carried out at the diabetes outpatient clinics of two tertiary care hospitals in Lahore, district of Punjab in Pakistan using convenience sampling techniques between December 1, 2015 and February 28, 2016. All consenting patients were interviewed to complete the Geriatric Depression Scale (GDS-15) and the Montreal Cognitive Assessment (MoCA). Standard scoring schemes were used for these scales. Multiple logistic regression analysis was carried out to identify any statistically significant variables from the univariate analysis, to segregate independent factors. A p value < .05 was taken as the mark of statistical significance for tests. A total of 490 elderly patients with type 2 diabetes mellitus were approached. Of those, 400 patients agreed to participate, resulting in a response rate of 81.6%. GDS-15 scores suggest that only 130 (32.5%) patients were not depressed to some degree. High HbA₁C and MCI were significant predictors of depression. MoCA scores indicated that 269 (67.3%) patients had MCI, and depression was the only predictor of MCI among the study patients. The implications of the findings include the need by healthcare providers to consider the assessment and management of depression and MCI as part of diabetes treatment protocols so that elderly patients can achieve positive diabetes outcomes and have improved health-related quality of life.