Volume : VI, Issue : IV, April - 2016

Correlates and predictors of abnormal results of EXIT25 test among diabetic elderly with normal MMSE score

Prof. Dr. Motassem Salah Amer, Dr. Somaia M. Ebeid, Dr. Hend Mahmoud Taha

Abstract :

 Background: Elderly population are rapidly growing sector of all societies, so more attention should be paid to their own problems. Diabetes mellitus is one of the common co–morbid conditions among the elderly with all its complications including cognitive impairment. Furthermore recent researches found a strong to and fro correlation between both, in other words diabetes mellitus is a risk factor for executive cognitive dysfunction which in turn is associated with bad glycemic control. Aim: The purpose of this study was to: – Find out a comprehensive method to detect executive cognitive dysfunction among diabetic elderly by gathering history taking, examination, investigations together with the neuropsychiatric tests. – Compå between EXIT 25 test and other five tests regarding their accuracy versus their eases of use(time, training) Methodology: Sixty elderly diabetic patients, both males and females, were recruited from the in–patient ward, Geriatric ICU and the out patient clinic of the Geriatric department, Ain–Shams University Hospital. After excluding other co–morbid conditions related to executive cognitive dysfunction, that all have normal scoring of MMSE, then the following were done: comprehensive geriatric assessment including history taking, examination and investigations. In addition six neuropsychiatric tests were applied (EXIT 25, Block design test, Verbal fluency test, Digit span forward, Digit span backward and contrast program test). Then statistical analysis was done. By using logistic stepwise multi–regression analysis, we can get the most sensitive ones that predict the dependant variable. Results: It was found that gender, educational level, smoking and presence of diabetic complications are statistically significant factors correlated to executive dysfunction by using EXIT 25 test. But no significant correlation with the lab. findings. And it was found also EXIT25 had the highest detection accuracy among other tests. Then by compå between EXIT 25 and other tests to find out the alternative tests to it with less time to be done, The most agreement was found between Exit25.2 and contrast program (66.7%), followed by verbal fl. (61.7%); block design 2 (60%); digital span2 (55%); digital span1(51.7%) and last clock drawing (41.6%). After multi–regression analysis : Verbal fleuncy together with serum creatinin level are the most sensitive marker for prediction of Exit25.2; thus impaired verbal fluency score together with increase serum creatinin can predict abnormal EXIT 25 score and vise versa(F–ratio = 5.696, p<0.01). Conclusion &Recommendation: – On the practical level selection of the tests used for detection of executive dysfunction depend on the associated co–morbidities – Regarding diabetic elderly assessment of executive function not merely by the neuropsychological test but also demographic clinical and lab. Assessment should be interpreted together. – Control of diabetes and cessation of smoking are considered reversible risk factors of executive dysfunction among the diabetic elderly. – Regarding the research level we recommend more assessment of the value of contrast program test to detect executive dysfunction , being rapid in administration and not in need of specialized personnel

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Prof. Dr. Motassem Salah Amer, Dr. Somaia M. Ebeid, Dr.Hend Mahmoud Taha Correlates and predictors of abnormal results of EXIT25 test among diabetic elderly with normal MMSE score Indian Journal of Applied Research, Vol.6, Issue : 4 April 2016

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