MON-646 - Incidence and Risk Factors of Mild Cognitive Impairment Among Filipino Patients Aged 60 Years Old and Above with Type 2 Diabetes Mellitus in A Tertiary Hospital in the Philippines: A Cross-Sectional Study

Background: Type 2 diabetes mellitus accelerates cognitive aging, imparting a 1.5-fold increased risk of decline driven by chronic hyperglycemia and oxidative stress. Because cognitive impairment significantly compromises self-management and medication adherence, optimal care for older adults necessitates routine screening and a comprehensive approach that addresses medical, functional, and psychosocial needs. This study aims to determine the incidence and risk factors of mild cognitive impairment (MCI) among Filipino patients aged 60 years and above with Type 2 Diabetes Mellitus (T2DM) in a tertiary hospital in the Philippines.

Methodology: This cross-sectional study included 164 literate, functionally independent diabetic patients aged 60 years and above seen in the outpatient clinic of a tertiary hospital. Patients with pre-existing neurocognitive, psychiatric, or significant sensory impairments, those with alcohol or substance abuse, and those who used cognition-impairing drugs in the past 4 weeks were excluded. Clinical, anthropometric, and metabolic data were extracted from electronic medical records. Cognitive status was evaluated using the Montreal Cognitive Assessment-Philippines (MoCA-P) tool, with a score of less than 21 defining MCI.

Results: Among 164 participants (mean age 68.8 ± 5.8 years), the incidence of MCI was 37.8% among older Filipino adults with T2DM, with predominant deficits observed in language and delayed recall. MCI was higher among individuals of older age, females, widowed, those with ≤12 years of education, and those with low or no income. Elevated systolic blood pressure and higher creatinine were associated with lower cognitive scores. Unlike typical mid-life risk factors, a higher Body Mass Index (BMI) in this older cohort was associated with better cognitive scores (φ = 0.20, p = 0.026). The most salient finding of this study is that education and occupation served as the strongest predictors of cognitive status. Univariate logistic regression identified low educational attainment (≤12 years) as a significant risk factor (OR = 2.01, p = 0.005). Conversely, higher occupational skill levels proved protective: Technicians/Associate Professionals (OR = 0.32, p = 0.04) and Managers/Professionals (OR = 0.14, p = 0.001) had significantly lower odds of MCI.

Conclusion: In summary, while maintaining an optimal blood pressure and renal function remains important, and higher BMI in older adults may reflect greater nutritional reserve vital for maintaining neuronal integrity, the study highlights that education and occupational complexity are the most significant determinants of cognitive health in older adults with T2DM. Future interventions for MCI prevention should consider not only metabolic control but also the promotion of cognitive engagement and social support, particularly for those with lower educational backgrounds.

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