Document Type : Research Paper


1 Department of Clinical Pharmacy, College of Pharmacy, University of Mosul, Mosul, Iraq

2 Faculty of Pharmacy &amp, Health Sciences, University of Balochistan, Quetta, Pakistan


Background: Early identification of cognitive weakening in previously undetected cases could help deal by starting programs for rehabilitation. Aim: The aim of this survey was to evaluate the prevalence and degree of cognitive impairment among adults of rural area in Nineveh, Iraq. Method: A cross-sectional study with convenient sampling technique was conducted to enroll subjects from a rural area in Nineveh. Cognitive function was examined in all the patients by the Saint Louis University Mental Status (SLUMS) is a screening tool for the cognitive state. A total of 213 agreed to participate in the survey with a mean age of 52.1 ± 11.8 years and higher percentage of participants were with primary level of education 125 (58.7%). Results: The mean score for the cognitive function examination was 18.85 ± 4.55 with significant differences were found between cognitive function and educational level, employment, and monthly income. Cognitive score was negatively correlated with age of participants (r= - 0.128, p value = 0.031). Although it was not significantly associated with level of education but around 43% of the study population suffered from mild cognitive impairment to dementia. Conclusion: The study concludes that there have been strong calls for program from the Ministry of Health to improve dementia care and support for societies with dementia and their occupations that will stay a life of that means and dignity. Efforts to make societies greater cognitively functioned, as well as, actively attractive patients will improve cost, the sustainable, treatment and care methods for diseases and quality of life.


Main Subjects

1.        Yerrapragada DB, Rao CR, Karunakaran K, Lee HSE. Cognitive dysfunction among adults with type 2 diabetes mellitus in Karnataka, India. Ochsner Journal 2019;19(3):227–34.
2.        Primožič S, Tavčar R, Avbelj M, Dernovšek MZ, Oblak MR. Specific cognitive abilities are associated with diabetes self-management behavior among patients with type 2 diabetes. Diabetes Research and Clinical Practice 2012;95(1):48–54.
3.        Weinstock RS, DuBose SN, Bergenstal RM, Chaytor NS, Peterson C, Olson BA, et al. Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes. Diabetes Care 2016;39(4):603–10.
4.        Nunes B, Silva RD, Cruz VT, Roriz JM, Pais J, Silva MC. Prevalence and pattern of cognitive impairment in rural and urban populations from Northern Portugal. BMC neurology 2010;10(1):1–12.
5.        Brownlee M. Advanced protein glycosylation in diabetes and aging. Annu Rev Med 1994;154:2473–9.
6.        Naguib R, Soliman ES, Neimatallah FM, AlKhudhairy NS, ALGhamdi AM, Almosa RS, et al. Cognitive impairment among patients with diabetes in Saudi Arabia: a cross-sectional study. Middle East Current Psychiatry 2020;27(1):1–11.
7.        Sullivan MD, Katon WJ, Lovato LC, Miller ME, Murray AM, Horowitz KR, et al. Association of depression with accelerated cognitive decline among patients with type 2 diabetes in the ACCORD-MIND trial. JAMA psychiatry 2013;70(10):1041–7.
8.        Nunley KA, Rosano C, Ryan CM, Jennings JR, Aizenstein HJ, Zgibor JC, et al. Clinically relevant cognitive impairment in Middle-Aged adults with childhood-onset type 1 diabetes. Diabetes Care 2015;38(9):1768–76.
9.        Mavrodaris A, Powell J, Thorogood M. Prevalences of dementia and cognitive impairment among older people in sub-Saharan Africa: a systematic review. Bulletin of the World Health Organization 2013;91:773–83.
10.      Amieva H, Mokri H, Le Goff M, Meillon C, Jacqmin-Gadda H, Foubert-Samier A, et al. Compensatory mechanisms in higher-educated subjects with Alzheimer’s disease: a study of 20 years of cognitive decline. Brain 2014;137(4):1167–75.
11.      Freddi Segai-Gidan PAC. Cognitive Screening Tools. Clinician Reviews 2013;23(1):12.
12.      Abdelrahman HMM, El Gaafary MM. Validation of Arabic Version of Saint - Louis - University - Mental - Status ( SLUMS ) - Examination and Prevalence of Cognitive Impairment in Community Dwelling Egyptian Older Adults. Middle East Journal of Age and Ageing 2014;11(4):11–9.
13.      Zhang DA, Lam V, Chu V, Li M. Type 2 Diabetes with comorbid depression in relation to cognitive impairment: an opportunity for prevention? Molecular neurobiology 2018;55(1):85–9.
14.      Malik A, Ahmed M, Mansoor S, Ambreen S, Usman B, Shehryar M. Cognitive Impairment in Type 2 Diabetes Mellitus. Cureus 2022;14(2).
15.      Luchsinger JA, Reitz C, Patel B, Tang MX, Manly JJ, Mayeux R. Relation of diabetes to mild cognitive impairment. Archives of neurology 2007;64(4):570–5.
16.      Gorska-Ciebiada M, Saryusz-Wolska M, Ciebiada M, Loba J. Mild cognitive impairment and depressive symptoms in elderly patients with diabetes: prevalence, risk factors, and comorbidity. Journal of diabetes research 2014;2014.
17.      Li W, Sun L, Li G, Xiao S. Prevalence, influence factors and cognitive characteristics of mild cognitive impairment in type 2 diabetes mellitus. Frontiers in aging neuroscience 2019;11:180.
18.      Shelke PS, Rajput RR, Kolte DR. Study of Cognitive Impairment and Existing Co-Morbidities Observed Among Geriatric Population in an Urban Slum. National Journal of Community Medicine 2019;10(05):256–61.
19.      Cukierman-Yaffe T, Gerstein HC, Williamson JD, Lazar RM, Lovato L, Miller ME, et al. Relationship between baseline glycemic control and cognitive function in individuals with type 2 diabetes and other cardiovascular rIsk factors the action to control cardiovascular risk in diabetes-memory in diabetes (ACCORD-MIND) trial. Diabetes Care 2009;32(2):221–6.
20.      Roy S, Kim N, Desai A, Komaragiri M, Baxi N, Jassil N, et al. Cognitive function and control of type 2 diabetes mellitus in young adults. North American journal of medical sciences 2015;7(5):220.
21.      Teixeira MM, Passos V, Barreto SM, Schmidt MI, Duncan BB, Beleigoli AMR, et al. Association between diabetes and cognitive function at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Scientific reports 2020;10(1):1–10.
22.      Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild  cognitive impairment. Journal of the American Geriatrics Society 2005;53(4):695–9.
23.      de Azeredo Passos VM, Giatti L, Bensenor I, Tiemeier H, Ikram MA, de Figueiredo RC, et al. Education plays a greater role than age in cognitive test performance among  participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). BMC neurology 2015;15:191.
24.      Tombaugh TN. Trail Making Test A and B: normative data stratified by age and education. Archives of clinical neuropsychology 2004;19(2):203–14.