cognitive impairment | Acta Medica Marisiensis

Prevalence of Depression, Anxiety and Cognitive Impairment in Patients with Type 2 Diabetes from the Central Part of Romania

Simona Cernea^1,2, Cristian Zoltai³, Daniela Berbecilă⁴, Floredana-Laura Şular^5,6

1 Department M3/Internal Medicine IV, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, Tîrgu Mureş, Romania
3 1st Psychiatry Clinic, County Clinical Hospital, Tîrgu Mureş, Romania
4 General Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
5 Central Laboratory, Emergency County Clinical Hospital, Tîrgu Mureş, Romania
6 Department M2/Laboratory Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

DOI: 10.1515/amma-2016-0014

Objective: The aim of this study was to assess the prevalence of depression, anxiety and cognitive impairment in patients with type 2 diabetes (T2D).
Material and methods: We conducted a cross-sectional study in patients with T2D. Depression and anxiety were assessed by questionnaires (PHQ-9, CES-D and GAD-7 respectively), cognitive function by the MoCA test. Additionally, 503 patients’ clinic charts were separately analyzed in order to compare the data recorded in the charts with that resulted from the active assessment.
Results: In the screening study 216 subjects with T2D were included (62.2 ± 7.8 years old). 34.3% of them had depression and 7.4% presented major depression. 44.9% of patients with T2D had anxiety (9.2% major anxiety) and this was highly correlated with depression (OR: 21.139, 95%CI: 9.767-45.751; p<0.0001). Women had significantly higher prevalence of depression and anxiety compared to men (42.1% vs. 21.7%; p: 0.0021 and 51.1% vs. 34.9%; p: 0.02), but severe depression was similar between genders (9.0% vs. 4.8%; p: 0.29). Significantly more patients had depression and anxiety than recorded in their charts (34.3% vs. 13.9% and 44.9% vs. 9.3%,respectively; p<0.0001 for both). 69.0% of T2D patients had mild, 6.0% had moderate and none had severe cognitive dysfunction, respectively. Significantly more patients with depression and anxiety had mild and moderate cognitive impairment (p: 0.03 and p: 0.04, respectively).
Conclusions: Patients with T2D had a high prevalence of comorbid depression, anxiety and cognitive impairment. Depression and anxiety were significantly more frequent in women. These conditions were under-evaluated and/or under-reported.

One of the most frequent forms of epilepsy in humans is temporal lobe epilepsy. Characteristic to this form of the disease is the frequent pharmacoresistance and the association with behavioural disorders and cognitive impairment. The objective of our study was to establish the degree of cognitive impairment in a rat model of temporal lobe epilepsy after an initial epileptogenic exposure but before of the onset of the effect of long-duration epilepsy.
Methods. For the experiment we used 11 rats. Status epilepticus was induced by systemic administration of a single dose of pilocarpine. The animals were continuously video-monitored to observe the occurrence of spontaneous recurrent seizures; during weeks 9-10 we performed eight-arm radial maze testing in order to assess the cognitive impairment.
Results. Animals developed spontaneous recurrent seizures after a 14-21 day latency with a daily average seizure density of 0.79±0.43 during weeks 9-10. Epileptic rats had significantly more working memory errors per session, more reference memory errors and the number of visited arms was also significantly higher. Accuracy was also lower in the pilocarpine treated group. Interestingly significant differences disappeared after six days of trials.
Conclusions. Our study shows behavioural deficits occurring after 9-10 weeks of epilepsy in the pilocarpine model of epilepsy applied to juvenile rats. In contrast to previous studies, we showed that juvenile rats with short duration of epilepsy are able to learn the behavioural task, therefore a morphopathological and/or behavioural “no-return point” regarding the development of severe cognitive impairment is not reached by status epilepticus alone.