Predictive Factors of Mild Cognitive Impairment Among Older Adults with Type 2 Diabetes Mellitus
Keywords:
Blood glucose level, Depression, Mild cognitive impairment, Older adults with type 2 diabetes mellitus, Physical functioning, Sleep qualityAbstract
Mild cognitive impairment (MCI) is commonly found among older adults with type 2 diabetes mellitus. This population is at greater risk of accelerated cognitive decline due to chronic metabolic abnormalities. Understanding the factors associated with MCI in this group is crucial for early detection and long-term prevention of dementia. This predictive correlational study aimed to examine the prevalence and predictive factors of MCI among older adults with type 2 diabetes mellitus. A total of 160 participants who received service at a sub-district health promoting hospital in San Sai District, Chiang Mai Province, were recruited. Data collection instruments included: (1) a demographic data form, (2) the Thai version of the Mild Cognitive Impairment assessment, (3) a sleep quality assessment questionnaire, (4) a depression assessment questionnaire, and (5) the 5-meter walk test. Data were analyzed using descriptive statistics, correlation analysis, and multiple regression analysis.
The results of this study revealed the following:
1. The prevalence of MCI among older adults with type 2 diabetes mellitus was 30% (M = 18.50, SD = 4.52). The mean blood glucose level was within the normal range (M = 120.91, SD = 27.11). Sleep quality was at a poor level (M = 6.56, SD = 3.20). The average depression score indicated no depression (M = 7.79, SD = 4.47). Physical function was at a poor level (M = 11.36, SD = 2.55).
2. Physical function was significantly negatively correlated with MCI (r = –.284, p < .01). Blood glucose level, sleep quality, and depression were not significantly associated with MCI.
3. Physical function significantly predicted MCI among older adults with type 2 diabetes mellitus, accounting for 75% of the variance. Among the predictors, physical functioning had the strongest predictive effect (β = –.284, p < .001).
Based on the study findings, diabetes management should be integrated with the monitoring and promotion of physical functioning in primary care settings to prevent or delay cognitive decline among older adults with type 2 diabetes mellitus.
References
Aekplakorn, W., Puckcharern, H., & Satheannoppakao, W. (2021). National health examination surveys (6th ed.). Aksorn Graphic and Design. (in Thai)
Afilalo, J., Sharma, A., Zhang, S., Brennan, J. M., Edwards, F. H., Mack, M. J., McClurken, J. B., Cleveland, J. C. Jr., Smith, P. K., Shahian, D. M., Peterson, E. D., & Alexander, K. P. (2018). Gait speed and 1-year mortality following cardiac surgery: A landmark analysis from the society of thoracic surgeons adultcardiac surgery database. Journal of the American Heart Association, 7(23), e010139. https://doi.org/10.1161/JAHA.118.010139
Alzheimer’s Association. (2022). More than normal aging: Understanding mild cognitive impairment. https://www.alzsd.org/wp-content/uploads/2023/03/Michelle-Reuwers-Summary-of-the-2022-Alzheimers-Disease-Facts-and-Figures-Report.pdf
Avery, J., Thomas, D., & Myshakivska, O. (2023). The effect of Mild Cognitive Impairment (MCI) on psychological distress among older adults in Ukraine. BMC Geriatrics, 23(1), 248. https://doi.org/10.1186/s12877-023-03906-1
Bahureksa, L., Najafi, B., Saleh, A., Sabbagh, M., Coon, D., Mohler, M. J., & Schwenk, M. (2017). The impact of mild cognitive impairment on gait and balance: A systematic review and meta-analysis of studies using instrumented assessment. Gerontology, 63(1), 67–83. https://doi.org/10.1159/000445831
Brain Rehabilitation Group. (1994). Thai geriatric depression scale. Siriraj Hospital Gazette, 46(1), 1–9. (in Thai)
Cai, Y. H., Wang, Z., Feng, L. Y., & Ni G. X. (2022). Effect of exercise on the cognitive function of older patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Frontiers in Human Neuroscience, 16, 876935. https://doi.org/10.3389/fnhum.2022.876935
Department of Medical Services, Ministry of Public Health. (2015). Guide for the elderlyscreening/ assessment (2nd ed.). War Veterans Organization Office of Printing Mill. https://dmscaretools.dms.go.th/geriatric/download/DMS_Aging_screening.pdf (in Thai)
Department of Older Persons. (2023). Situation of Thai older persons 2022. Amarin Corporations. https://library.anamai.moph.go.th/mmi/Main/cvr/000/004/690/8/240531-135343-27123_2565_eng.pdf (in Thai)
Eze, C., Basil, E., Uma, A., & Ikenna, O. (2015). The prevalence of cognitive impairment amongst type 2 diabetes mellitus patients at Abakaliki South-East Nigeria. Journal of Metabolic Syndrome, 4, 1-3. https://doi.org/10.4172/2167-0943.1000171
Frech, F. H., Li, G., Juday, T., Ding, Y., Mattke, S., Khachaturian, A., Rosenberg, A. S., Ndiba-Markey, C., Rava, A., Batrla, R., De Santi, S., & Hampel, H. (2024). Economic impact of progression from mild cognitive impairment to alzheimer disease in the United States. The Journal of Prevention of Alzheimer's Disease, 11(4), 983-991. https://doi.org/10.14283/jpad.2024.68
Gao, F., Wei, S., Dang, L., Gao, Y., Gao, L., Shang, S., Chen, C., Huo, K., Wang, J., Wang, J., & Qu, Q. (2022). Sleep disturbance is associated with mild cognitive impairment: A community population-based cross-sectional study. BMC Public Health, 22(1), 2000. https://doi.org/10.1186/s12889-022-14391-3
Gray, M., Gills, J. L., Glenn, J. M., Vincenzo, J. L., Walter, C. S., Madero, E. N., Hall, A., Fuseya, N., & Bott, N. T. (2021). Cognitive decline negatively impacts physical function. Experimental Gerontology, 143, 111164. https://doi.org/10.1016/j.exger.2020.111164
Hemrungrojn, S., Tangwongchai, S., Charoenboon, T., Panasawat, M., Supasitthumrong, T., Chaipresertsud, P., Maleevach, P., Likitjaroen, Y., Phanthumchinda, K., & Maes, M. (2021). Use of the montreal cognitive assessment thai version to discriminate amnestic mild cognitive impairment from Alzheimer's disease and healthy controls: Machine learning results. Dementia and Geriatric Cognitive Disorders, 50(2), 183–194. https://doi.org/10.1159/000517822
Hwang, E. J. (2022). Analysis of factors associated with subjective Mild Cognitive Impairment (MCI) among older adults resident in the community. International Journal of Environmental Research and Public Health, 19(16), 10387. https://doi.org/10.3390/ijerph191610387
Khullar, S., Kaur, G., Dhillon, H., Sharma, R., Mehta, K., Singh, M., & Singh, P. (2017). The prevalence and predictors of cognitive impairment in type 2 diabetic population of Punjab, India. Journal of Social Health and Diabetes, 5(1), 47-53. https://doi.org/10.1007/s10597-015-9985-y
Konopka, L. M. (2015). How exercise influences the brain: A neuroscience perspective. Croatian Medical Journal, 56(2), 169-171. https://doi.org/10.3325/cmj.2015.56.169
Li, W., Yue, L., Sun, L., & Xiao, S. (2021). Elevated fasting plasma glucose is associated with an increased risk of MCI: A community-based cross-sectional study. Front Endocrinol (Lausanne), 12, 739257. https://doi.org/10.3389/fendo.2021.739257
Mignardot, J. B., Beauchet, O., Annweiler, C., Cornu, C., & Deschamps, T. (2014). Postural sway, falls, and cognitive status: A cross-sectional study among older adults. Journal of Alzheimer's Disease, 41(2), 431–439. https://doi.org/10.3233/JAD-132657
Ministry of Public Health. (2025). Incidence rate of new diabetes cases per 100,000 population in the fiscal year. https://hdc.moph.go.th/center/public/standard-report-detail/eeeab22e386d32e7f5f5ecefebce0001?subcatalogId=6a1fdf282fd28180eed7d1cfe0155e11 (in Thai)
Montero-Odasso, M., Oteng-Amoako, A., Speechley, M., Gopaul, K., Beauchet, O., Annweiler, C., & Muir-Hunter, S. W. (2014). The motor signature of mild cognitive impairment: Results from the gait and brain study. The Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 69(11), 1415–1421. https://doi.org/10.1093/gerona/glu155
Osborne, J. W. (2000). Prediction in multiple regression. Practical Assessment, Research & Evaluation, 7(1), 2. https://doi.org/10.7275/7j20-gg86
Petersen, R. C., Lopez, O., Armstrong, M. J., Getchius, T. S. D., Ganguli, M., Gloss, D., Gronseth, G. S., Marson, D., Pringsheim, T., Day, G. S., Sager, M., Stevens, J., & Rae-Grant, A. (2018). Practice guideline update summary: Mild cognitive impairment [RETIRED]: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology, 90(3), 126-135. https://doi.org/10.1212/WNL.0000000000004826
Sitasuwan, T., Bussaratid, S., Ruttanaumpawan, P., & Chotinaiwattarakul, W. (2014). Reliabilityand validity of the Thai version of the Pittsburgh sleep quality index. Journal of Medical Association Thailand, 97(Suppl. 3), S57-S67.
Smith, L., Shin, J. I., López Sánchez, G. F., Oh, H., Kostev, K., Jacob, L., Law, C. T., Carmichael, C., Tully, M. A., & Koyanagi, A. (2022). Social participation and mild cognitive impairment in low- and middle-income countries. Preventive Medicine, 164, 107230. https://doi.org/10.1016/j.ypmed.2022.107230
Subindee, S., & Sritanyarat, W. (2014). Mild cognitive impairment in older persons with chronic illness attended at a chronic care clinic of a primary care unit Khon Kaen Province. Journal of Nursing Science & Health, 37(1), 43-50. https://he01.tci-thaijo.org/index.php/nah/article/view/19747/17288 (in Thai)
Valenza, S., Paciaroni, L., Paolini, S., Bonfigli, A. R., Di Rosa, M., Rabini, R. A., Tortato, E., Pelliccioni, P., & Pelliccioni, G. (2020). Mild cognitive impairment subtypes and type 2 diabetes in elderly subjects. Journal of Clinical Medicine, 9(7), 2055. https://doi.org/10.3390/jcm9072055
You, Y., Liu, Z., Chen, Y., Xu, Y., Qin, J., Guo, S., Huang, J., & Tao, J. (2021). The prevalence of mild cognitive impairment in type 2 diabetes mellitus patients: A systematic review and meta-analysis. Acta Diabetologica, 58(6), 671–685. https://doi.org/10.1007/s00592-020-01648-9
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Nursing Journal CMU
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลสาร
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับมหาวิทยาลัยเชียงใหม่ และคณาจารย์ท่านอื่นๆในมหาวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
