[Influencing factors of cognitive function decline in elderly patients with type 2 diabetes mellitus]

The global prevalence of type 2 diabetes mellitus (T2DM) continues to rise, and cognitive impairment caused by T2DM is particularly common among elderly patients. This study aims to explore the influencing factors of cognitive function decline in elderly patients with T2DM, so as to provide references for the prevention of cognitive impairment in elderly patients with T2DM.

A total of 376 patients aged over 60 years with T2DM without cognitive impairment who visited the Department of Geriatrics and Endocrinology of Third Xiangya Hospital for the first time from June 2019 to December 2020 were selected. General information, lifestyle behaviors, laboratory-related indicators, activities of daily living, and depression scores were collected. One year after discharge, cognitive function was reassessed. According to the reassessment scores, patients were divided into a cognitive function maintenance group and a cognitive function decline group. Logistic regression analysis was used to explore the risk factors for cognitive function decline in elderly patients with T2DM.

The incidence of cognitive function decline in elderly patients with T2DM at 1 year was 13.3%. Univariate analysis revealed that there were statistically significant differences between the cognitive function decline group and the cognitive function maintenance group in age, educational level, marital status, smoking history, amount of physical exercise, housework performance, Instrumental Activities of Daily Living (IADL) score, and 2 hours postprandial glucose (2hPG) (P<0.05). Multivariate logistic regression analysis showed that age (OR=2.795, 95% CI 1.785 to 4.375, P<0.001), 2hPG (OR=1.232, 95% CI 1.087 to 1.397, P=0.001), housework performance (OR=2.438, 95% CI 1.017 to 5.844, P=0.046), and physical exercise time ≥1 hour/day (OR=0.107, 95% CI 0.012 to 0.916, P=0.041) were independent influencing factors for cognitive function decline in patients with T2DM.

Advanced age, high 2hPG, less housework, and physical exercise time <1 hour/day are risk factors for cognitive function decline in patients with T2DM. Reasonable control of postprandial blood glucose and increasing physical activity and housework time may help delay cognitive function decline in patients with T2DM.