Cognitive Impairments In Type 2 Diabetes Mellitus: Clinical And Biochemical Correlations

Abstract

Background. Cognitive impairments are increasingly recognized as significant complications of Type 2 Diabetes Mellitus (T2DM), adversely affecting daily functioning, treatment adherence, and quality of life. Recent evidence suggests that metabolic dysregulation, endothelial dysfunction, and neuroinflammatory mechanisms contribute to the development of cognitive decline in diabetic patients. However, the interplay between biochemical markers such as glycated hemoglobin (HbA1c), adiponectin, and soluble vascular cell adhesion molecule-1 (sVCAM-1) and neuropsychological performance remains insufficiently explored. Objective. To evaluate the clinical and biochemical correlations of cognitive impairments in patients with Type 2 Diabetes Mellitus using standardized neuropsychological tests and serum biomarker levels. Methods. A cross-sectional analytical study was conducted at the Department of Neurology, Tashkent State Medical University from 2022 to 2024. The study included four groups: (1) T2DM with mild cognitive impairment; (2) T2DM with dementia; (3) T2DM without cognitive impairment; (4) healthy controls. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Stroop Test, and Hospital Anxiety and Depression Scale (HADS). Serum HbA1c, total adiponectin, and sVCAM-1 levels were measured using ELISA. Statistical analyses included correlation tests and regression modeling. Results. Patients with T2DM and cognitive impairment demonstrated significantly higher HbA1c and sVCAM-1 levels and lower adiponectin levels compared with both diabetic patients without cognitive impairment and healthy controls (p < 0.05). MoCA and FAB scores showed strong inverse correlations with HbA1c (r = –0.52, p < 0.01) and sVCAM-1 (r = –0.47, p < 0.01). Adiponectin demonstrated a positive correlation with cognitive scores (r = +0.44, p < 0.01). These findings support the concept of metabolic–vascular–neuroinflammatory interplay in diabetic cognitive dysfunction. Conclusion. Cognitive decline in T2DM is closely linked with biochemical alterations such as elevated HbA1c and sVCAM-1 and reduced adiponectin. These biomarkers may serve as early indicators of cognitive impairment and should be incorporated into comprehensive assessment strategies for diabetic patients.