Cognitive Impairment in People with Type 2 Diabetes Mellitus: Associations with Inflammatory and Vascular Markers

Abstract

Background Type 2 diabetes mellitus (T2DM) is associated with metabolic, vascular and cognitive complications. Although mild cognitive impairment (MCI) is increasingly recognised in T2DM, its relationship with inflammatory and vascular markers remains underexplored in India. Purpose This study investigated the association between high-sensitivity C-reactive protein (hs-CRP), carotid intima-media thickness (CIMT) and cognitive status in individuals with T2DM. Methods This cross-sectional study included 117 adults aged 40–65 years with T2DM of at least 5 years’ duration, recruited from a tertiary care hospital in Mysuru. Cognitive function was assessed using the Saint Louis University Mental Status Scale. Clinical, anthropometric, biochemical and vascular parameters, including hs-CRP and CIMT, were measured. Group comparisons and correlation analyses were conducted. Results MCI was present in 47.9% of participants. Education level was significantly associated with cognitive status (p = .001). Participants with MCI exhibited higher hs-CRP levels (p = .007) and greater CIMT (p = .001) compared to those with normal cognition. Correlation analyses demonstrated negative associations between SLUMS scores, hs-CRP and CIMT. Receiver operating characteristic analysis indicated fair predictive value for hs-CRP (AUC = 0.64) and CIMT (AUC = 0.70). Conclusion Lower educational attainment, higher hs-CRP levels and greater CIMT were associated with MCI among individuals with T2DM. These findings suggest that inflammatory and vascular markers may be useful in identifying individuals at greater risk of cognitive impairment. However, longitudinal studies are required to determine temporal and causal relationships.