Association of Cognitive Impairment with Co-occurrence of Hypertension and Type 2 Diabetes Mellitus among People Living with Diabetes: A Population-based Study

Abstract: Introduction: Cognitive impairment has been associated with 24% higher risk of death in old age. Type 2 diabetes mellitus (T2DM) and hypertension (HTN) have become global health challenges, reshaping public health priorities. Reportedly, cognitive function declines with an increase in T2DM as well as HTN, but the effect of the presence of both conditions on cognitive function has not been well-researched. Objective: This study aimed to determine the effect of the co-occurrence of T2DM and HTN on cognitive impairment among community-dwelling adults. Materials and Methods: The data of a cross-sectional study done on 450 community-dwelling rural people living with T2DM, aged 35 years and above, in the south-central part of India were analyzed. Cognitive impairment was tested using the Hindi Mental State Examination tool. Blood pressure, fasting blood sugar, and hemoglobin A1c were measured using standard lab protocols. Data on sociodemographic variables, anthropometry, physical activity, and comorbidities were collected using a structured-questionnaire. Data analysis was done using Statistical Package for the Social Sciencesversion 25. Logistic regression models were created to report the independently associated variables with cognitive impairment among those with coexistent T2DM and HTN. Results: Participants (46.4%) had co-occurrence of T2DM and HTN. Among them, 87.1% had cognitive impairment. Cognitive impairment was significantly higher among the diabetes–HTN co-occurrence group than in the diabetes-only group (0.01). Co-occurrence of T2DM and HTN was associated with a twofold increase in risk of cognitive impairment among men, but not among women ( P < 0.03). Conclusion: Co-occurrence of HTN and T2DM was associated with greater cognitive impairment in men alone. Co-occurrence of HTN with T2DM was higher in the older age group; cognitive impairment was greater among adults with T2DM with HTN.