Utilization of Frontal Assessment Battery and Executive Interview 25 in assessing for dysexecutive syndrome and its association with diabetes self-care in elderly patients with type 2 diabetes mellitus

Aims: Executive function (EF) comprises a set of cognitive skills that controls the execution of complex activities. In the context of diabetes, this may include patients' self-monitoring and daily management of their condition. We compared two different measures of EF in a population of elderly patients with type 2 diabetes mellitus (T2DM) and studied its relationship with diabetes self-care. Methods: Fifty patients (34 males) had EF assessed using Frontal Assessment Battery (FAB) and Executive Interview 25 (EXIT25). Diabetes self-care was assessed using the Summary of Diabetes Self-Care Activities (SDSCA) scale. Haemoglobin A1c (HbA1c), lipid levels, blood pressure and diabetes duration were recorded. Results: The mean age of the patients was 67.0 +/- 7.5 years and mean duration of diabetes was 8.1 +/- 6.4 years. Mean HbA1c was 7.0 +/- 1.2%, and mean fasting plasma glucose, cholesterol and LDL-C were 7.0 +/- 1.7 mM, 4.0 +/- 0.9 mM and 2.1 +/- 0.7 mM respectively. Mean EXIT25 score was 9.5 +/- 4.6 in the range of normal EF (14% had EXIT25 score > 15, indicating impaired EF). Mean FAB score was 13.7 +/- 3.3 (48% having scores < 15, indicating impaired EF), suggesting a degree of dysexecutive syndrome involving frontal lobe functions. EXIT25 score was inversely correlated with SDSCA (r = -0.3, p < 0.05) but no significant correlation between FAB and SDSCA or HbA1c, diabetes duration, lipid levels and blood pressure dwith EXIT25, FAB or SDCSA was found. Conclusion: A substantial proportion of elderly patients with T2DM may have dysexecutive syndrome and impairment in EF may impact on self-care in this group. (C) 2009 Elsevier Ireland Ltd. All rights reserved.