The Influence Of Sedentary Time On Mild Cogntive Impairment

ObjectivesThis study aims to:(1)analysis of the relationship between sedentary time,sleep quality,glycosylated hemoglobin and mild cognitive impairment in elderly patients with type 2 diabetes;(2)identify latent classes of sleep quality among in older adults with type 2 diabetes based on latent class model and explore the relationship between the latent classes and mild cognitive impairment;(3)construct a model of the mediating effect of sedentary time on mild cognitive impairment,and to explore the mediating effect of glycosylated hemoglobin and sleep quality.The ultimate goal is to provide a scientific foundation for preventing and managing this condition,promoting the overall health of these patients,and enhancing their quality of life.MethodsConvenience sampling was used to select patients aged 60 and above from the Department of Endocrinology,Qilu Hospital,Shandong University,who were diagnosed with type 2 diabetes between October 2021 and October 2022.These patients were divided into two groups:those with type 2 diabetes and mild cognitive impairment(T2DM-MCI),and those with type 2 diabetes and normal cognitive function(T2DM-NCF).Data was collected through self-administered questionnaires that included socio-demographic and disease-related information,the Pittsburgh Sleep Quality Index Inventory(PSQI),the Montreal Cognitive Assessment Scale(MoCA),the International Physical Activity Questionnaire(IPAQ),the Activities of Daily Living Scale(ADL),and the 5-item Geriatric Depression Scale(GDS-5).Face-to-face interviews were conducted to administer the questionnaires.Statistical analysis of the data was conducted using SPSS26.0 software and Mplus 8.0 software,with the primary statistical methods comprising descriptive analysis,one-way regression analysis,correlation analysis,binary logistic regression,potential profile analysis,and mediating effect analysis.Results(1)The study encompassed 146 elderly patients with type 2 diabetes and mild cognitive impairment(T2DM-MCI)and 111 elderly patients with type 2 diabetes and normal cognitive function(T2DM-NCF).Significant differences were observed in scores pertaining to visuospatial and executive function,naming,attention and computation,verbal ability,thinking,memory,and orientation between the two groups.(2)Multi-factor binary logistic regression analysis showed that the more sedentary time was more likely to have mild cognitive impairment(OR=1.44,P=0.002);the poorer the quality of sleep,the more likely elderly T2DM patients were to have mild cognitive impairment(OR=1.33,P<0.001),and the higher the glycosylated hemoglobin level,the more likely elderly T2DM patients were to have mild cognitive impairment(OR=1.11,P=0.030).(3)Potential profile analysis indicated that sleep in elderly T2DM patients could be segmented into three potential categories:"better sleep quality group"(22.2%),"poor sleep quality without hypnotic drugs group"(65.0%),and "poor sleep quality with hypnotic drugs group"(12.8%).(4)Binary logistic regression analysis revealed that,compared to the "good sleep quality group",the "poor sleep quality without hypnotic medication group"(OR=3.34,p<0.001)and the "poor sleep quality with hypnotic medication group"(OR=2.50,P=0.025)had a higher likelihood of mild cognitive impairment.After adjusting for covariates,the "poor sleep quality without hypnotics group" was more likely to develop MCI,with odds 2.50 times higher than the "good sleep quality group"(OR=2.50,P=0.025).However,the "poor sleep quality with hypnotics group" did not show a statistically significant difference.(5)Mediating effect analysis demonstrated that glycosylated hemoglobin and sleep quality partially mediated the relationship between sedentary behavior and mild cognitive impairment,accounting for 8.6%and 12.3%of the total effect respectively.Conclusions1.Sedentary time,sleep quality,and glycosylated hemoglobin were all associated with T2DM-MCI in the elderly.2.There is noticeable group heterogeneity in the sleep patterns of elderly T2DM patients,which can be categorized into "good sleep quality group","poor sleep without sleeping pills group",and "poor sleep with sleeping pills group".3.Compared to the "good sleep quality group",the "poor sleep quality without hypnotics group" is more likely to develop MCI,warranting further attention.It is worth noting that the risk of mild cognitive impairment was not increased in the "poor sleep quality and hypnotic group" compared to the "good sleep quality group",which needs to be further investigated in future studies.4.glycosylated hemoglobin and sleep quality partially mediate the relationship between sedentary behavior and mild cognitive impairment in elderly T2DM patients.