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Title: The prevalence of undiagnosed cognitive impairment and prevalence of undiagnosed depressive mood in over 60's with type 2 diabetes in a Thai community : a cross-sectional study
Author: Trongsakul, Supaporn
ISNI:       0000 0004 2745 028X
Awarding Body: University of East Anglia
Current Institution: University of East Anglia
Date of Award: 2012
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Type 2 diabetes is a lifelong disease and a major health problem in Thai older people. Declining cognitive function and depressive mood can potentially present a barrier to self-care management. To date, there is no primary research data of cognitive impairment related to diabetes in Thailand, particularly in primary care settings which are the first important place for health care service in Thai community. This study contributes to the estimated prevalence of undiagnosed cognitive impairment and undiagnosed depressive mood in Thai older people with type 2 diabetes. In order to promote an early detection of cognitive impairment, a Thai version of Mini-Cog, a brief cognitive screening test for using in primary care settings was developed. A cross-sectional study design was conducted in a group of older diabetic patients aged 60 and over in the primary care settings of San-sai district, Chiang Mai, Thailand. Overall 556 participants were recruited and the following screening tests were applied on them: Mini-Cog Thai version, Mini-Mental State Examination (MMSE) Thai 2002, and the depressive mood screening test of Thai Geriatric Depression Scale (TGDS). The study shows the prevalence of Thai older people with type 2 diabetes who were probably undiagnosed with cognitive impairment to be 65.4% (95% CI 59.7%, 70.7%) for Mini-Cog, and 12.4% (95% CI 9.0%, 16.7%) for MMSE Thai 2002. The prevalence of people who were probably undiagnosed with depressive mood by TGDS is shown to be 19.4% (95% CI 15.2%, 24.4%). Logistic regression has been used to identify the associated characteristics of cognitive impairment and the associated characteristics of depressive mood. Using Mini-Cog, age, education, BMI and HDL were found to have effects on cognitive impairment. While using MMSE Thai 2002, only the effect of age and education were associated with cognitive impairment. The associated factor with depressive mood was retinopathy. The differences of prevalence rate and associated characteristics between the two cognitive screening tests are probably due to the different foci on cognitive domain tests. Mini-Cog may be more sensitive in detecting an earlier stage of cognitive impairment better than MMSE Thai 2002. Mini-Cog Thai version shows a good inter-rater reliability (K=0.8, p<0.001, 95% CI 0.54, 1.06). This study encourages health care providers’ awareness of cognitive decline and depressive mood that may affect self-care diabetes. Mini-Cog Thai version might be used as a brief cognitive screening tool in primary care settings.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available