Key result
Female vs male sex showed no significant difference in severe cognitive impairment (50.00% vs 47.06%), while age, diastolic blood pressure, and depressive symptoms increased odds.
Why the study?
Although AF and T2DM are associated with cognitive decline, possible sex-related differences in cognitive and functional outcomes remain uncertain.
Cross-Sectional (n=140)
In patients with type 2 diabetes mellitus and atrial fibrillation with cognitive decline, rates of severe cognitive impairment are similar between men and women, and are associated with older age, higher diastolic blood pressure, greater depressive symptoms, and lower functional independence in both sexes.
No sex difference supports uniform cognitive screening in T2DM with AF; leaves open whether targeting age, diastolic pressure, or depression alters outcomes.
Background/Aim: Atrial fibrillation (AF) and type 2 diabetes mellitus (T2DM) are associated with cognitive decline, but possible sex-related differences in cognitive and functional outcomes remain uncertain. This exploratory study evaluated sex-stratified associations of clinical factors, depressive symptoms, and functional independence with severe cognitive impairment in patients with T2DM, AF, and newly identified cognitive decline. Patients and Methods: The study included 140 patients with T2DM, AF, and a Mini-Mental State Examination (MMSE) score <27, comprising 68 men and 72 women. Cognitive performance, depressive symptoms, and functional status were assessed using the MMSE, Montreal Cognitive Assessment, 15-item Geriatric Depression Scale (GDS-15), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living scales. Logistic regression was used to evaluate factors associated with severe cognitive impairment, defined as MMSE <24, in the overall cohort and separately in male and female patients. Results: Severe cognitive impairment was present in 32/68 men (47.06%) and 36/72 women (50.00%), with no significant difference between sexes. Increasing age and higher diastolic blood pressure were associated with higher odds of MMSE <24 in the overall cohort and in sex-stratified analyses. Higher GDS-15 scores were associated with increased odds of severe cognitive impairment in both sexes, whereas greater functional independence, reflected by higher ADL scores, was associated with lower odds of MMSE <24. Conclusion: Age, higher diastolic blood pressure, and greater depressive symptom burden in patients with type 2 diabetes mellitus were associated with increased odds of severe cognitive impairment, whereas greater functional independence was associated with lower odds in both sexes. These exploratory findings support cognitive, cardiovascular, psychological, and functional assessment in patients with T2DM and AF.
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Militaru et al. (2026) conducted a cross-sectional in Type 2 diabetes mellitus, atrial fibrillation, and newly identified cognitive decline (n=140). Female sex vs. Male sex was evaluated on Severe cognitive impairment, defined as Mini-Mental State Examination (MMSE) score <24. Female vs male sex showed no significant difference in severe cognitive impairment (50.00% vs 47.06%), while age, diastolic blood pressure, and depressive symptoms increased odds.
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