Psychological and Clinical Predictors of Cognitive Failures Among Adults With Type 2 Diabetes Mellitus: A Hierarchical Regression Study

Abstract

Cognitive problems are now acknowledged as a significant complication of Type 2 diabetes mellitus (T2DM). Although biological markers like glycemic control (HbA1c level) are known to be important contributors of cognitive decline, there is increasing evidence that psychological and behavioral factors may be more of a significant contribution to cognitive functioning in the real world. But, the role of demographic, clinical and psychological factors in cognitive failures has not been fully understood.

In the present study, the authors sought to determine the demographic, clinical and psychological factors associated with the occurrence of cognitive failures in Type 2 Diabetic adults. To explore the relative contribution of the demographic variables (age, gender), clinical variables (duration of diabetes and HbA1c) and psychological variables (diabetes distress, sleep quality, cognitive reserve) on the prediction of cognitive failures, a hierarchical multiple regression analysis was performed.

A positive correlation was found between diabetes distress and sleep quality while a negative correlation was found between cognitive reserve and cognitive failures; the results of the correlation analyses were confirmed. Demographic and clinical variables accounted for a modest amount of variance in cognitive failures, as shown by hierarchical regression analysis. Including psychological variables caused a significant increase in the amount of variance explained, from 10.0% to 55.6%. In the final model, diabetes distress and sleep quality emerged as significant predictors of cognitive failures, whereas age, diabetes duration, HbA1c level, and cognitive reserve were not significant unique predictors.

These results indicate that psychological and behavioral factors play a more significant role in psychological failures compared to conventional clinical measures in adults with T2DM. The findings are consistent with the need to implement a biopsychosocial care model when working with a patient with diabetes and suggest that diabetes distress and sleep quality may serve as targets for interventions aimed at enhancing cognitive functioning.