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Objective <p>This cross-sectional study examined associations among sedentary behavior, sleep quality, glycemic control, and mild cognitive impairment (MCI) in older adults with type 2 diabetes mellitus (T2DM), and explored latent sleep profiles and their associations with MCI.</p> Methods <p>From October 2021 to October 2022, 257 patients with T2DM aged ≥ 60 years were recruited from a tertiary hospital in Jinan, China. Cognitive status was operationalized using a structured study framework that combined MoCA screening with education adjustment, assessment of daily functioning, clinical exclusion criteria, and exclusion of dementia. </p> <p>Participants were classified as having T2DM with MCI (T2DM-MCI; <i>n</i> = 146) or T2DM with normal cognitive function (T2DM-NCF; <i>n</i> = 111). Analyses included descriptive statistics, group comparisons, complete-case logistic regression, latent profile analysis (LPA), a PSQI cutoff plus hypnotic-medication classification, sensitivity analyses, correlation analysis, and cross-sectional indirect-effect models, including exploratory parallel and serial models.</p> Results <p>Among the 257 participants, 146 were classified as T2DM-MCI and 111 as T2DM-NCF. LPA identified three sleep profiles: good sleep, poor sleep with low hypnotic-medication use, and poor sleep with high hypnotic-medication use. A simpler PSQI cutoff plus hypnotic-medication classification showed a broadly similar pattern. In adjusted logistic regression, the poor sleep with low hypnotic-medication use profile was associated with higher odds of MCI than the good sleep profile (OR = 2.50, <i>p</i> = 0.025), whereas the poor sleep with high hypnotic-medication use profile was not statistically significant. Exploratory indirect-effect models suggested significant total indirect effects through HbA1c and PSQI score, but the order-specific serial pathways were not statistically significant. These findings should not be interpreted as evidence of temporal or causal mediation.</p> Conclusion <p>Sedentary time, PSQI score, and HbA1c were associated with MCI in older adults with T2DM.</p> <p>These findings support further longitudinal research on multidimensional interventions addressing sedentary behavior, sleep, and glycemic management; however, causal conclusions cannot be drawn from this cross-sectional study.</p>

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The relationship between sedentary time, sleep quality, glycemic control, and mild cognitive impairment in older adults with type 2 diabetes mellitus

  • 期刊论文

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  • 发表日期：

    2026年7月9日

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  • Jingzheng Yan,
  • Zhichao Wei,
  • Ruiqun Chen,
  • Yingjuan Cao

摘要

Objective

This cross-sectional study examined associations among sedentary behavior, sleep quality, glycemic control, and mild cognitive impairment (MCI) in older adults with type 2 diabetes mellitus (T2DM), and explored latent sleep profiles and their associations with MCI.

Methods

From October 2021 to October 2022, 257 patients with T2DM aged ≥ 60 years were recruited from a tertiary hospital in Jinan, China. Cognitive status was operationalized using a structured study framework that combined MoCA screening with education adjustment, assessment of daily functioning, clinical exclusion criteria, and exclusion of dementia.

Participants were classified as having T2DM with MCI (T2DM-MCI; n = 146) or T2DM with normal cognitive function (T2DM-NCF; n = 111). Analyses included descriptive statistics, group comparisons, complete-case logistic regression, latent profile analysis (LPA), a PSQI cutoff plus hypnotic-medication classification, sensitivity analyses, correlation analysis, and cross-sectional indirect-effect models, including exploratory parallel and serial models.

Results

Among the 257 participants, 146 were classified as T2DM-MCI and 111 as T2DM-NCF. LPA identified three sleep profiles: good sleep, poor sleep with low hypnotic-medication use, and poor sleep with high hypnotic-medication use. A simpler PSQI cutoff plus hypnotic-medication classification showed a broadly similar pattern. In adjusted logistic regression, the poor sleep with low hypnotic-medication use profile was associated with higher odds of MCI than the good sleep profile (OR = 2.50, p = 0.025), whereas the poor sleep with high hypnotic-medication use profile was not statistically significant. Exploratory indirect-effect models suggested significant total indirect effects through HbA1c and PSQI score, but the order-specific serial pathways were not statistically significant. These findings should not be interpreted as evidence of temporal or causal mediation.

Conclusion

Sedentary time, PSQI score, and HbA1c were associated with MCI in older adults with T2DM.

These findings support further longitudinal research on multidimensional interventions addressing sedentary behavior, sleep, and glycemic management; however, causal conclusions cannot be drawn from this cross-sectional study.