Assessment of Cognitive Function and Functional Performance in Patients With Type 2 Diabetes

Postural stability will be assessed using the Biodex Balance System®. This assessment is performed to evaluate the individual's ability to maintain the center of body mass.

Deviations from the center of balance will be recorded during the test. Higher stability index scores indicate greater deviation from the center of balance and poorer postural stability.

This assessment will be conducted using the Biodex Balance System®. The test will be performed on a static platform. The purpose of the test is to evaluate the individual's ability to shift and control the center of body mass within the base of support.

Directional control (overall, forward, backward, left, right, forward/left, forward/right, backward/left, backward/right) will be assessed and expressed as a percentage (%).

Higher scores are associated with better postural control.

This assessment will be conducted using the Biodex Balance System®. The purpose of the test is to evaluate how different sensory inputs contribute to the maintenance of balance and how well balance can be preserved when one or more of these sensory inputs are removed.

The test will be performed under the following conditions: eyes open and eyes closed on a firm surface, and eyes open and eyes closed on a foam surface.

A sway index will be calculated for each condition.

The Stroop Test is used to assess cognitive function, including processing speed, selective attention, cognitive flexibility, and the ability to inhibit automatic responses.The test consists of three parts, in which participants are required to perform color-word tasks. The completion time of the test will be recorded in seconds.

The Mini-Mental State Examination (MMSE) will be used to assess general cognitive function. The test evaluates the domains of orientation, attention, memory, calculation, and language. The total score ranges from 0 to 30, with higher scores indicating better cognitive performance.

It is used to assess dynamic balance during obstacle negotiation. The patient is instructed to step over four canes placed on the floor in a cross configuration, following a specified sequence.

The completion time of the test is recorded in seconds.

Functional capacity will be assessed using the 6-minute walk test. This test involves participants walking along a 30-meter corridor at their own pace for six minutes, with the distance recorded in meters. At the end of six minutes, the participant is informed that the test is complete and the test is terminated. The expected average walking distance for healthy individuals ranges from 400 to 700 meters.

Lower extremity muscle strength will be assessed using the 30-second chair stand test.

During the test, participants will be instructed to stand up from a chair for 30 seconds with their arms crossed over their chest and their feet flat on the floor.

The number of completed stands will be recorded to evaluate functional lower extremity muscle strength.

Quadriceps femoris muscle strength will be assessed using an electronic hand-held dynamometer.Participants will be instructed to sit with the knee in full extension, while the physiotherapist applies maximal resistance at the ankle to evaluate the isometric strength of the quadriceps femoris muscle.The muscle strength value will be recorded in kilograms (kg).

To assess fear of falling, fear of falling will be assessed using the Falls Efficacy Scale-International (FES-I).The scale consists of 16 items that assess individuals' levels of concern related to falling during daily activities.Each item is scored from 1 (not at all concerned) to 4 (very concerned).

The total score will be recorded.

The Functional Reach Test is performed to assess fall risk. During the test, participants are instructed to stand, raise the arm to approximately 90 degrees, and reach forward as far as possible without stepping or losing balance.The distance between the starting position of the hand and the furthest point reached is recorded in centimeters (cm).Values of 15 cm or less indicate an increased risk of falling.

The Timed Up and Go (TUG) Test is performed to assess fall risk. The test requires a chair and a stopwatch. A 3-meter distance is marked in front of the chair, and participants are instructed to stand up from the chair on the command "go," walk this distance at a normal pace, and sit down again.

The completion time of the test is recorded in seconds. Longer completion times are associated with an increased risk of falling.

Quality of life will be assessed using the WHOQOL-BREF questionnaire. The WHOQOL-BREF consists of four domains: physical health (7 items), psychological well-being (6 items), social relationships (3 items), and environmental health (8 items). All items are rated on a 5-point Likert scale and scored from 1 to 5.

Body mass index will be taken into consideration during evaluation. Body height (m) will be measured using standardized procedures, and body weight (kg) will be measured using the Omron BF511 Body Composition Monitor. Body Mass Index (BMI) will be calculated by dividing body weight (kg) by the square of height in meters (kg/m²).

Body fat mass (kg) will be measured using the Omron BF511 Body Composition Monitor according to the standard protocol of the device.

Skeletal muscle mass (kg) will be measured using the Omron BF511 Body Composition Monitor according to the standard protocol of the device.

Resting metabolic rate (kcal) will be assessed using the Omron BF511 Body Composition Monitor.

Visceral fat level will be assessed using the Omron BF511 Body Composition Monitor according to the manufacturer's instructions.