A new nomogram model for the individualized prediction of mild cognitive impairment in elderly patients with type 2 diabetes mellitus.

Background: A high risk of developing mild cognitive impairment (MCI) is faced by elderly patients with type 2 diabetes mellitus (T2DM). In this study, independent risk factors for MCI in elderly patients with T2DM were investigated, and an individualized nomogram model was developed. Methods: In this study, clinical data of elderly patients with T2DM admitted to the endocrine ward of the hospital from November 2021 to March 2023 were collected to evaluate cognitive function using the Montreal Cognitive Assessment scale. To screen the independent risk factors for MCI in elderly patients with T2DM, a logistic multifactorial regression model was employed. In addition, a nomogram to detect MCI was developed based on the findings of logistic multifactorial regression analysis. Furthermore, the accuracy of the prediction model was evaluated using calibration and receiver operating characteristic curves. Finally, decision curve analysis was used to evaluate the clinical utility of the nomogram. Results: In this study, 306 patients were included. Among them, 186 patients were identified as having MCI. The results of multivariate logistic regression analysis demonstrated that educational level, duration of diabetes, depression, glycated hemoglobin, walking speed, and sedentary duration were independently correlated with MCI, and correlation analyses showed which influencing factors were significantly correlated with cognitive function (p <0.05). The nomogram based on these factors had an area under the curve of 0.893 (95%CI:0.856-0.930)(p <0.05), and the sensitivity and specificity were 0.785 and 0.850, respectively. An adequate fit of the nomogram in the predictive value was demonstrated by the calibration plot. Conclusions: The nomogram developed in this study exhibits high accuracy in predicting the occurrence of cognitive dysfunction in elderly patients with T2DM, thereby offering a clinical basis for detecting MCI in patients with T2DM.

Perceptions and responses to cognitive decline in people with diabetes: A systematic review of qualitative studies.

Objective: We aimed at summarizing the perceptions and responses to cognitive decline, assessing the disease management, identifying deficiencies and proposing new strategies for improvement in people with diabetes (PWDs). Methods: A comprehensive search was performed in the following nine databases: PubMed, EMBASE, Web of Science, The Cochrane Library, PsycINFO, CINAHL, WanFang, CNKI, and VIP. The Joanna Briggs Institute (JBI) Critical Appraisal Tool for qualitative research was utilized to evaluate the quality of included studies. Descriptive texts and quotations relating to patient experience were extracted from the included studies and thematically analyzed. Results: Eight qualitative studies met the inclusion criteria and 2 overarching themes were identified: (1) self-perception of cognitive decline referred to perceived cognitive symptoms, lack of knowledge and, impaired self-management and coping in multiple methods; (2) reported benefits of cognitive interventions referred to how cognitive interventions improved disease management, attitudes and needs of PWDs. Conclusion: PWDs described misconceptions about their cognitive decline and suffered from them during disease management. This study provides a patient-specific reference for cognitive screening and intervention in PWDs, supporting disease management with cognitive decline in clinical practice.

Prospective association between standing balance and cognitive function in middle-aged and older Chinese adults.

Objective: To investigate the association of standing balance with cognitive functions and the rate of cognitive decline among middle-aged and older Chinese adults. Methods: Participants were selected from China's Health and Retirement Longitudinal Study. A total of 8,499 subjects aged ≥45 years who participated in wave 1 to wave 3 surveys were included in the final analysis. Standing balance was measured using the tandem test, and participants were categorized into two groups according to their ability to maintain standing balance. Cognitive functions were assessed in three domains: episodic memory, mental status, and global cognition. The associations between standing balance scores, cognitive scores, and the rate of cognitive decline were evaluated using linear regression and linear mixed models. Results: Compared with participants who successfully completed the standing balance test, those who were unable to complete the test had lower scores on episodic memory [ß = -0.18; 95% confidence interval (CI): -0.24, -0.11], mental status (ß = -0.28; 95% CI: -0.37, -0.19), and global cognition (ß = -0.51; 95% CI: -0.65, -0.38) after 4 years of follow-up. In addition, the rate of decline in mental status and global cognition increased by 0.10 (ß = 0.10; 95% CI: 0.07, 0.13) and 0.08 (ß = 0.08; 95% CI: 0.04, 0.12) units, respectively, in participants who were unable to complete the test compared with their counterparts. Conclusion: Good standing balance was significantly associated with higher cognitive function and a lower decline in mental status and global cognition in middle-aged and older Chinese adults.

Patterns of multimorbidity in association with falls among the middle-aged and older adults: results from the China Health and Retirement Longitudinal Study.

BACKGROUND: Chronic diseases are important risk factors of falls. However, most studies explored the effect of a single chronic disease on falls and few studies explored the combined effect of multiple chronic diseases on falls. In this study, we examined the associations between falls and multimorbidity and multimorbidity patterns. METHODS: Data collected between 2011 and 2018 were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multimorbidity was defined as the coexistence of ≥ 2 chronic diseases in the same person. The multimorbidity patterns were identified with exploratory factor analysis (EFA). The longitudinal associations of multimorbidity and multimorbidity patterns with falls were examined with generalized estimating equations methodology. RESULTS: Compared with patients without chronic conditions, patients with one, two, and ≥ 3 chronic diseases had 37%, 85%, and 175% increased risk of falls, respectively. The EFA identified four multimorbidity patterns and the factor scores in the cardiac-metabolic pattern [adjusted odds ratio (aOR): 1.16, 95% confidence interval (95% CI): 1.12-1.20)], visceral-arthritic pattern (aOR: 1.31, 95% CI: 1.28-1.35), respiratory pattern (aOR: 1.12, 95% CI: 1.10-1.16), and mental-sensory pattern (aOR: 1.31, 95% CI: 1.28-1.35) were all associated with a higher risk of falls. CONCLUSION: Multimorbidity and multimorbidity patterns are related to falls. Older adults with multiple chronic diseases require early interventions to prevent falls.

The Effects of Aromatherapy on Anxiety and Depression in People With Cancer: A Systematic Review and Meta-Analysis.

Background: Anxiety and depression are highly prevalent in people with cancer. Medical therapies are usually prescribed to alleviate anxiety and depression, but they are associated with a variety of adverse effects. Recently, aromatherapy showed potential as a complementary medicine to improve psychological health and wellbeing. However, its effectiveness on relieving anxiety and depression has not been established. Objective: This study explored the beneficial effects of aromatherapy on psychological symptoms such as anxiety and depression in people with cancer. Methods: We searched international databases including PubMed, Web of Science, Cochrane Library, Embase, Medline, Ebscohost, ProQuest and Scopus from inception to 31 May 2021. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias. The systematic review and meta-analysis were performed according to the PRISMA guidelines. Quantitative analysis was performed on the studies that met our inclusion criteria, and Meta-analysis was performed on the studies with available data by RevMan software. Results: The quality of the literatures were assessed carefully by two researchers, a total of 17 studies were included in the systematic review and 10 articles were conducted in meta-analysis. The aromatherapy was effective in relieving anxiety (SMD = -0.49, p < 0.05) in people with cancer. Subgroup analysis suggested that most effective methods were aromatic massage (SMD = -0.70, p < 0.005), aromatherapy with lavender essential oils (SMD = -1.12, p < 0.01), short-time interventions (duration < 4weeks) (SMD = -0.87, p < 0.05) and studies in Asia (SMD = -0.83, p < 0.05). Regarding depression and psychological wellbeing, there were no difference between aromatherapy and control groups. Conclusion: In cancer patients, the aromatherapy was effective for relieving anxiety. However, there was no beneficial effect on depression and psychological wellbeing. Systematic Review Registration: PROSPERO, identifier: CRD42021272465.