NEUROCOGNITIVE IMPAIRMENT AND ASSOCIATED FACTORS AMONG ADULTS WITH TYPE 2 DIABETES MELLITUS WHO ARE ATTENDING OUT PATIENT DEPARTMENT AT PUBLIC HOSPITALS OF HARARI REGIONAL STATE AND DIRE DAWA CITY ADMINISTRATION, EASTERN ETHIOPIA

Abstract

Background: Neurocognitive impairment is described as a significant or modest cognitive decline from a previous level of performance in one or more cognitive domains such as attention, executive function, learning and memory, language, perception, or motor activities and interferes with independence in everyday activities. According to a recent systematic review and meta-analysis, up to 45% of people with type 2 diabetes mellitus have neurocognitive impairment.Worldwide more than 50 million people live with a cognitive impairment, 60% of them live in lower and middle-income countries. Even though its number is projected to increase to 152 million by 2050, there is not enough data from low and middle-income countries, including Ethiopian population. Objective: To assess the prevalence of neurocognitive impairment and associated factors among adults living with type 2 diabetes mellitus attending public hospitals in Harari regional state and Dire Dawa City Administration from February 7 to March 7, 2024. Methods: An institutional-based cross-sectional study was conducted among 418 adults living with type 2 diabetes mellitus attending public hospitals in Harari regional state and Dire Dawa City Administration, eastern Ethiopia. A systematic sampling technique was used to select the study participants. Cognitive function was evaluated by using the Rowland Universal Dementia Assessment Scale. Data were collected through a structured and pre-tested interviewer administered questionnaire, then entered into EPI Data Version3.1 software and analyzed using STATA Version 14. A multivariable logistic regression analysis was used to identify the associated factors of neurocognitive impairment among the participants with a p-value less than 0.05. Results: In this study from 400 patients with type 2 diabetes mellitus who were used in the analysis, the overall prevalence of neurocognitive impairment among people living with type 2 diabetes mellitus was 42.5% (95 % CI: 37, 47.3). Age older than 60 year (AOR=3.8.; 95% CI: 1.70, 8.74), duration of the illness >10 years (AOR=3.6.; 95% CI: 1.83, 7.15), comorbid medical illness (AOR=4.4.; 95% CI: 2.44, 8.09), current alcohol use (AOR=3.6; 95% CI: 2.10, 6.25), depression (AOR=5.6; 95% CI: 3.24, 9.98), were statistically associated with neurocognitive impairment. xi Conclusion: The study found a high prevalence of neurocognitive impairment among people living with type 2 diabetes mellitus. Factors such as age greater than 60 years, the presence of comorbidity, duration of the disease greater than 10 years, having depression, and current alcohol use were statistically associated with neurocognitive impairment among people living with type 2 diabetes mellitus. Therefore, assessment and management of neurocognitive impairment should be part of routine medical care in diabetic follow-up clinics, with special attention for those whose age is greater than 60 years, who have comorbid medical illnesses, whose duration of the disease is greater than 10 years, who have depression, and who currently use alcohol.