Diabetes and social support associations with cognitive impairment in elderly schizophrenia inpatients
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Key Takeaway
Note that higher social support and ADL scores are associated with lower cognitive impairment odds in this cohort.
This retrospective cross-sectional study evaluated 149 elderly inpatients with schizophrenia in an inpatient setting. The researchers examined clinical characteristics, metabolic indicators, activities of daily living (ADL), and perceived social support (MSPSS) to identify factors associated with cognitive impairment, defined as a MoCA score < 26.
Results showed a 47.7% prevalence of cognitive impairment within the cohort. Higher MSPSS total scores were independently associated with lower odds of cognitive impairment (OR = 0.609, 95% CI: 0.469-0.791, p < 0.001). Similarly, higher ADL scores were associated with lower odds of impairment (OR = 0.553, 95% CI: 0.379-0.806, p = 0.002). Diabetes mellitus was associated with increased odds of cognitive impairment (OR = 7.735, 95% CI: 1.129-52.979, p = 0.037).
Using K-means clustering, the study identified three phenotypes significantly associated with cognitive impairment status (χ2 = 137.58, p < 0.001), with a model classification accuracy of 96.6%. Safety and tolerability data were not reported.
A key limitation is the wide confidence interval for the diabetes mellitus association, which indicates limited precision. Because this was a retrospective cross-sectional study, the identified associations do not imply causation. These findings may support the potential value of stratified nursing management, but prospective studies are warranted to validate these results.
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View Original Abstract ↓
ObjectiveTo examine the prevalence of cognitive impairment and factors associated with cognitive impairment among elderly patients with schizophrenia, and to explore potential clinical phenotypes using a clustering approach.MethodsA retrospective cross-sectional study was conducted among 149 elderly inpatients with schizophrenia. Cognitive impairment was defined as Montreal Cognitive Assessment (MoCA) score < 26. Clinical characteristics, metabolic indicators, activities of daily living (ADL), and perceived social support (MSPSS) were collected. Multivariate logistic regression was performed to identify factors associated with cognitive impairment. Model classification performance was evaluated using a 2 × 2 table. K-means clustering was applied to explore cognitive and social functioning phenotypes.ResultsThe prevalence of cognitive impairment among elderly patients with schizophrenia was 47.7%. Multivariate logistic regression analysis showed that higher MSPSS total score (OR = 0.609, 95% CI: 0.469-0.791, p < 0.001) and higher ADL score (OR = 0.553, 95% CI: 0.379-0.806, p = 0.002) were independently associated with lower odds of cognitive impairment. Diabetes mellitus was associated with increased odds (OR = 7.735, 95% CI: 1.129-52.979, p = 0.037), although the wide confidence interval indicates limited precision. The model demonstrated good classification performance (accuracy = 96.6%). K-means clustering identified three phenotypes (optimal functioning, mild-to-moderate impairment, and severe impairment), which were significantly associated with cognitive impairment status (χ² = 137.58, p < 0.001).ConclusionCognitive impairment is prevalent among elderly patients with schizophrenia and is associated with reduced social support, lower functional independence, and diabetes. Cluster analysis suggests heterogeneity in cognitive and psychosocial profiles, supporting the potential value of stratified nursing management. Prospective studies are warranted to validate these findings.
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