Specific Cognitive Functions Associated With Self-Care Behaviors in Older Adults With Type 2 Diabetes and Mild Cognitive Impairment

Background: Diabetes is prevalent in older adults and is associated with increased cognitive impairment. Self-care behavior is essential for glycemic control and complication prevention for type 2 diabetes and requires various degrees of cognitive function for self-care. Studies exploring the effect of mild cognitive impairment (MCI) on self-care behaviors in older adults with type 2 diabetes remain limited. Objective: We sought to investigate the association between mild cognitive impairment and self-care behaviors in older adults with type 2 diabetes. Methods: This cross-sectional study included older adults with type 2 diabetes at a medical center in Taiwan. Data collection included sociodemographic and clinical information, a self-care behavior questionnaire, and neuropsychological tests of cognitive functioning, including executive function, memory, and psychomotor speed. Data were analyzed using multiple regression analysis. Results: A total of 272 older adults with diabetes participated in the study. Participants with MCI had significantly lower scores on prevention and treatment of high and low blood glucose behavior than those with normal cognition. After adjusting for other factors, poorer executive function was significantly associated with lower self-care behaviors and reduced exercise behavior, and reduced psychomotor speed was significantly linked to poorer foot care behavior. Conclusions: Reduced cognitive functioning domains such as executive function and psychomotor speed were associated with poorer self-care behaviors in older adults with type 2 diabetes and MCI. Prospective, long-term studies are needed to further understand the changes and causal relationships between MCI and diabetes self-care behaviors.