Association between sleep quality and mild cognitive impairment in Chinese patients with type 2 diabetes mellitus: a cross-sectional study

Abstract

Abstract Background Globally, the number of individuals with type 2 diabetes mellitus (T2DM) is increasing, and they are at a higher risk of developing mild cognitive impairment (MCI) than the general population. Sleep quality is thought to be a modifiable factor that may contribute to MCI, as previous studies have linked it to cognitive function in older adults. However, evidence concerning the association between sleep quality and MCI among patients with T2DM in China is limited. Therefore, this study aims to identify the association between sleep quality and MCI among patients with T2DM in China. Methods This cross-sectional study was conducted among patients with T2DM who were referred to the Endocrinology Department of Xiangya Hospital, Central South University. Data regarding sociodemographic characteristics, lifestyle factors, T2DM-related information, and biochemical indicators were collected. Sleep quality and MCI were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Mini-Mental State Examination (MMSE) scale, respectively. The association between sleep quality and MCI was analyzed using univariate and multivariate analyses. Results This study included 1,001 patients with T2DM, with a mean age of 60.2 (standard deviation: 10.1) years. Pearson’s correlation analysis showed that the total PSQI score was negatively associated with the MMSE score (r=-0.27, P < 0.05). Multivariate analyses based on four models consistently showed that those with higher total PSQI score (aOR = 1.09–1.11, P < 0.05), as well as higher scores on the subjective sleep quality (aOR = 1.32–1.46, P < 0.05), sleep latency (aOR = 1.25–1.32, P < 0.05), sleep duration (aOR = 1.30–1.32, P < 0.05), sleep efficiency (aOR = 1.36–1.41, P < 0.05), sleep disturbance (aOR = 1.66–1.86, P < 0.05), and daily dysfunction (aOR = 1.38–1.48, P < 0.05) were associated with higher rates of MCI. Conclusions Among Chinese patients with T2DM, poor overall sleep quality, subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, and daily dysfunction were associated with higher rates of MCI. Future studies are needed to examine whether sleep intervention could improve cognitive function in patients with T2DM. It is also suggested for clinicians working with T2DM patients to raise the awareness of cognitive impairment and sleep problems.

Keywords

• Type 2 diabetes mellitus
• Sleep quality
• Mild cognitive impairment
• Chinese