Características cognitivas de idosos diabéticos atendos na atenção primária durante a pandemia de covid-19: um estudo transversal

Introduction: aging associated with Type 2 Diabetes Mellitus (T2DM) increases the risk of cognitive impairment in older adults. During the COVID-19 pandemic, social isolation, disruption of Primary Health Care follow-up, and greater clinical vulnerability may have worsened cognitive health, especially in rural areas of the Amazonas state. Objective: to describe cognitive characteristics and their association with sociodemographic and clinical factors among older adults with Type 2 Diabetes Mellitus receiving Primary Health Care in the interior of Amazonas. Methods: this cross-sectional observational study included 58 older adults monitored by Primary Health Care Units in Coari, Amazonas, during the COVID-19 pandemic. Home-based data collection was conducted following biosafety protocols. Sociodemographic and health data were obtained using a semi-structured questionnaire. Cognitive assessment included the Mini-Mental State Examination (MMSE) and Verbal Fluency Test (VFT), administered by previously trained researchers. The results were expressed as regression coefficients (β), 95% confidence intervals (95% CI), and p-values. Analyses were performed using the Statistical Package for the Social Sciences (SPSS), version 20.0, adopting a significance level of 5% (p < 0.05). Results: most participants were women (68.9%), aged 60–69 years (76.3%), and had low educational levels (78%). Regarding health conditions, 71.1% used diabetes medication, 60.5% used insulin, and 42.1% had inadequate glycemic control. Cognitive deficit was identified in 42.1% of participants by MMSE and in 22% by VFT, with performance associated with educational level. After adjustment for sex, age, education, race/color, and income, no significant association was observed between MMSE and VFT scores (coefficient=0.14; p=0.254). Conclusion: older adults with T2DM showed high frequencies of low education, inadequate glycemic control, and cognitive deficits, reinforcing the need for early cognitive screening and culturally adapted health education strategies.