Objectives: Early cognitive impairment is common in people with type 2 diabetes (T2DM). Subjective cognitive symptoms (SCS) have been associated with higher risks for early dementia and mild cognitive impairment and may be an early indication of further cognitive decline. Our goal was to identify factors related to SCS in people with T2DM to facilitate early screening for cognitive impairment in this population.

Methods: A convenience sample of 115 adults with T2D was included. The cognitive symptom subscale of the Diabetes Symptom Checklist-Revised was used. Potential factors were measured using the Patient-Reported Outcomes Measurement Information System including depression, fatigue, and sleep. Data were analyzed using quantile regression which accounts for non-normal distribution of the dependent variable. Quantile regression was useful to examine the relationships along the continuum of SCS severity that may be missed in traditional linear regression.

Results: The mean age of the participants was 58.64 (SD 8.64), and 53.9% were females. The mean score of the cognitive symptom subscale was 1.45 (SD 1.14, range 0 to 5). Using quantile regression, we found that increased sleep impairment (r = .02), sleep disruption (r = .02 to .05), and body mass index (r = .02) were significantly associated with increased SCS when the participants’ cognitive symptoms were in the lower quantiles (from .05 to .30). In contrast, increased depressive symptoms (r = .05 to .07) and fatigue (r = .04 to .06) were significantly associated with increased SCS in the higher quantiles of cognitive symptoms (from .70 to .95).

Conclusions: In adults with T2DM, the level of SCS is differentially associated with common diabetes factors and should be considered when screening and intervening for cognitive impairment. Sleep and weight should be considered for patients reporting fewer cognitive symptoms, whereas depression and fatigue should be considered for patients reporting more cognitive symptoms.


M. Kim: None. C.G. Park: None. B. Zhu: None. C. Fritschi: None.


National Institute for Nursing Research (K99R00NR012219); University of Illinois at Chicago College of Nursing

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