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Advances in Therapy

Evaluation of Frequency, Severity and Spectrum of Cognitive Impairment and Its Associated Risk Factors in Elderly Individuals with Diabetes in India: A Prospective Observational Cohort Study

Authors
Anu Gupta
Yashdeep Gupta
Vineeta Garg
Roopa Rajan
Venugopalan Y. Vishnu
Nikhil Tandon
Published in
Advances in Therapy

Abstract

Introduction

Cognitive impairment in type 2 diabetes mellitus affects self-management of the disease, creating a vicious cycle of worsening cognitive and glycaemic control. Low- and middle-income countries are underrepresented in research focusing on this association. This study aimed to evaluate the frequency, severity, spectrum and risk factors associated with cognitive impairment in elderly individuals with diabetes in India.

Methods

Elderly participants aged 60 years and above underwent a comprehensive clinical, biochemical and neuropsychological evaluation (cognitive concerns, neuropsychological testing and functional activity assessments).

Results

A total of 832 participants were included: 698 with diabetes and 134 without diabetes. Participants with diabetes had a mean age of 65.2 ± 4.5 years and average HbA1c level of 7.8 ± 1.8%. Cognitive impairment (NIA-AA 2018 criteria for cognitive staging) was identified in 75 participants (9.2%), with a higher prevalence in the group with diabetes (10.7%) compared to the group without diabetes (1.5%) [adjusted odds ratio (OR) 9.1 (95% CI 2.1–39.4)]. Gender-based subgroup analysis did not reach statistical significance [female participants, OR 3.7 (95% CI 0.76–18.4), p = 0.11]. Risk factors for cognitive impairment included increasing age [OR 1.1 (95% CI 1.02–1.14)] and unemployment [OR 2.5 (95% CI 1.2–5.4)], while protective factors included higher education [OR 0.86 (95% CI 0.82–0.92)] and physical activity [OR 0.99 (95% CI 0.99–0.99)].

Conclusion

Cognitive impairment affects one in ten elderly Indians with type 2 diabetes mellitus. Factors affecting cognitive reserve are a crucial, modifiable determinant of cognitive function in these individuals.
Title
Evaluation of Frequency, Severity and Spectrum of Cognitive Impairment and Its Associated Risk Factors in Elderly Individuals with Diabetes in India: A Prospective Observational Cohort Study
Authors
Anu Gupta
Yashdeep Gupta
Vineeta Garg
Roopa Rajan
Venugopalan Y. Vishnu
Nikhil Tandon
Publication date
02-04-2026
Publisher
Springer Healthcare
Published in
Advances in Therapy
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-026-03549-9
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