Cognitive disorders

Abstract

Cognition is a continuous process that allows us to adapt to environmental challenges. It is a complex of systems that are part of the central and peripheral nervous systems and their effectors, that is, the musculoskeletal system. Its response depends on their interaction. Failure in one of these systems leads to cognitive decline, loss of sensation and motor function, and vice versa.

This interaction can develop, improve, or be affected by neglect or by chronic and systemic pathologies such as diabetes mellitus (DM). Understanding this allows us to tailor education, non-pharmacological resources, and pharmacological treatments so that its impact throughout the natural history of diabetes does not contribute to the progressive decline of a person's abilities, and so that these abilities are maintained or regressed from a stage that could be considered pre-symptomatic: frailty.

We encourage a holistic understanding of human beings and its application in daily practice, as the decline in cognitive abilities, emotional control, learning, and mobility in older adults with diabetes mellitus (DM) constitutes a global socio-health problem given the high prevalence of the disease, its impact on the health system and society, and the burden of suffering for those affected and their families.

In this review, we highlight the problem, its causes, presentation, and natural history. We propose a prevention and treatment approach, since the older adult stage is characterized by its heterogeneity and resource scarcity. This is a call to raise awareness and consider aging as simply another stage of human life, a stage that can be "healthy" or accompanied by pathological processes that affect the quality of life of the individual and their environment. It is important to consider the search for new strategies and resources to address this problem.

We emphasize that DM is the most frequent metabolic problem in older adults, affecting 30% of them. All cells in the body are affected because they share basic mechanisms for nutrient utilization. The central nervous system consumes the largest amount of nutrients, making it one of the most affected systems. We have an opportunity to apply our accumulated knowledge to understand diabetes and the resources available to us. In this review, we provide an overview of these resources and their relationship to the prevention and treatment of this metabolic and neurological condition.