Study on the Current Status and Influencing Factors of Mild Cognitive Impairment in Elderly Patients with Type 2 Diabetes Mellitus from the Perspective of "Physical Disease-related Adjustable Constitution": a Case Study in Sichuan Province

Background The global rise in the prevalence of type 2 diabetes mellitus (T2DM) among the elderly has emerged as a significant public health concern. T2DM is known to exert detrimental effects on cognitive function. However, there remains a lack of simple and effective indicators for the early detection and monitoring of this condition, highlighting an urgent need for further investigation. The present study utilizes real-world cross-sectional data to explore the disease from the perspective of "physical disease-related adjustable constitution" offering potential clinical value for the diagnosis and treatment. Objective To investigate the prevalence of type 2 diabetes mellitus with mild cognitive impairment (MCI) among the elderly in the Sichuan region, and to identify the factors influencing its occurrence. Methods Elderly patients aged ≥60 years with type 2 diabetes mellitus were selected for the survey conducted from November 2021 to November 2023. The participants were recruited from various communities and three nursing homes across six cities in Sichuan Province, namely Chengdu, Deyang, Bazhong, Emeishan, Meishan, and Mianyang. A face-to-face survey was administered using a paper-based questionnaire, which collected basic demographic information, the Changsha version of the Montreal Cognitive Assessment (MoCA), and the Traditional Chinese Medicine constitution assessment. Univariate analysis, followed by multifactorial Logistic regression, was performed to identify potential independent factors influencing the occurrence of type 2 diabetes mellitus with MCI. Pearson correlation analysis was used to explore the correlation between different cognitive domains and yang deficiency constitution. Results A total of 407 questionnaires were distributed, of which 397 were valid, yielding a response rate of 97.54%. Among the 397 participants, 348 (87.7%) were elderly individuals residing in communities, and 49 (12.3%) were from nursing homes. A total of 84 participants were identified with MCI, resulting in a prevalence of 21.2% for T2DM with MCI. Based on cognitive status, participants were divided into two groups: those with T2DM and MCI (n=84) and those with T2DM without MCI (n=313). Statistically significant differences were observed between the two groups in terms of education level, depression, reading books and newspapers, as well as Traditional Chinese Medicine (TCM) constitutions including qi deficiency, yang deficiency, phlegm-dampness, and damp-heat (P