Depression as a Risk Factor for Dementia among aged People with Type 2 Diabetes
Hossam Egila *
Neurology Department, Faculty of Medicine, Mansoura University, Egypt.
Monzer Mustafa
Neurology Department, Faculty of Medicine, Mansoura University, Egypt.
Ahmed Esmael
Neurology Department, Faculty of Medicine, Mansoura University, Egypt.
Shady Alrashedy
Neurology Department, Faculty of Medicine, Mansoura University, Egypt.
Ibrahem Hamdey Rashed Elkalla
Psychiatry Department, Faculty of Medicine, Mansoura University, Egypt.
Sahar El Emam Gad
Psychiatry Department, Faculty of Medicine, Mansoura University, Egypt.
Fady Azmy Kyrillos
Diabetes and Endocrinology Department, Faculty of Medicine, Mansoura University, Egypt.
Mohammed Abbas
Neurology Department, Faculty of Medicine, Mansoura University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Objective: The aim of this study is to detect the relation between depression and dementia in patients with type 2 diabetes mellitus (DM).
Methods: Clinically diagnosed Type 2 diabetes underwent screening for depression using Beck's Depression Inventory scale and subsequent risk of dementia defined using medical reports, prescription data and death certificates. The mediating act of inflammation systemically was measured by assessing three inflammatory markers (C reactive protein, ESR and Fibrinogen).
Results: The study was conducted on 102 diabetic type 2 patients, included 48 males and 54 females. Patients divided into 12 (11.7%) patients with depression and 90 (88.3%) patients without depression (mean age 61±8.6 and 60.9±9.2 respectively). Mean BMI (body mass index) in depressive patients was 33.5 ± 9.3 and was 31.9 ± 8.9 in non-depressive cases (P value 0.01). There were no significant differences in patients with and without depression regarding the presence of hypertension, hyperlipidemia and smoking as risk factors of dementia. Patients with depression had significant impaired cognition and the total MoCA (Montereal Cognitive Assessment) scores were significantly lower than those of patients without depression (23.21 ± 3.48 vs 26.34 ± 3.78, P <0.05). Complication of diabetes in patients with depression as neuropathy was significant (P value 0.005). Other complications as diabetic retinopathy and nephropathy were non-significant. Inflammatory markers levels in patients with depressive symptoms were significantly higher (P value < 0.01).
Conclusion: In patients with type 2 diabetes, there is an important association between dementia and depression. Systemic inflammation had a significant role in the relation between depression and dementia.
Keywords: Depression, dementia, diabetes mellitus, inflammatory markers